Grant: Project Grant

The economic burden of blindness in Canada is estimated at $15.8 billion annually. Age-related macular degeneration (ARMD) and diabetic retinopathy (DR) are the leading causes of blindness in Canada overall and among working age people respectively. Outcomes from these diseases can be greatly improved through the use of drugs that inhibit Vascular Endothelial Growth Factor (VEGF), which plays a central role in both conditions. Our previous work demonstrated the rapid uptake of VEGF inhibiting drugs, with ranibizumab now the greatest cost for public drug insurance plans in many jurisdictions. Aflibercept use has also rapidly expanded recently following positive clinical trial results and favourable economic analyses. Although VEGF inhibitors have been linked to serious adverse events, little evidence exists regarding the comparative safety of aflibercept and ranibizumab. The goal of the proposed research is to improve health policy and patient care by providing the first population-based data comparing the safety of aflibercept and ranibizumab. We will use linked, validated, population-based administrative health databases to identify all Ontario citizens treated with VEGF inhibitors for ARMD and DR, and assess the association between their exposure to aflibercept or ranibizumab and the risk of adverse vascular and renal events. We have established an interprofessional research team with scientific expertise and experience translating research findings to advance health policy and patient care. The proposed project will impact billions of dollars of health care spending and is linked to the data needs of key health care policy and clinical care organizations including provincial ministries of health. Through ongoing integrated knowledge translation linkages and established clinical leadership roles, the team is poised to directly and significantly improve drug policies and patient care across Canada and beyond.