Retina TodayManaging Without Copay Assistance Programs

⚖️ Legal / Ethical Complexity

Reduced copay assistance is changing retina workflows for patients receiving chronic high-cost intravitreal therapy. Practices report more counseling, treatment substitution, and affordability discussions.

Professional Impact

• Good Days funding constraints have left some patients unable to re-enroll or newly access assistance.
• Medicare Advantage patients face particular pressure because manufacturer copay programs cannot support federal plans.
• Retina practices report switches to repackaged bevacizumab, sample use, and selected interval extension.
• ASRS survey data cited in the article found 93% of respondents switched patients to bevacizumab.

Action Items

• Review financial counseling workflows for patients receiving chronic retina therapy.
• Document copay, deductible, and assistance-program discussions before treatment changes.
• Monitor clinical response after switching agents or extending intervals.
• Evaluate insurance education resources for patients with chronic retinal disease.