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Table 2 Summary of patients’ requests for funding of Ranibizumab (source: authors’ analysis of data from Clalit Mushlams’ cohort of members funding applications, March 1, 2012 to December 31, 2015)

From: Cost containment by peer prior authorization program for second line treatment in patients with retinal disease

Previously approved Tx Pt applying Pt dropped out from previous Tx Total No′ of applications Mean No′ of applications per Pt Pt approved w/o further scrutiny Pt approved after repeated application Pt not receiving funding Total Pt approved for funding
N (%) N (%) N (%) N (%)
0 5642 6452 1.1 4740 (84.0%) 614 (10.9%) 288 (5.1%) 5354 (94.9%)
1 3325 2029 4143 1.2 2519 (75.8%) 588 (17.7%) 218 (6.5%) 3107 (93.5%)
2 2005 1102 2454 1.2 1556 (77.6%) 321 (16.0%) 128 (6.4%) 1877 (93.6%)
3 1233 644 1478 1.2 986 (80.0%) 184 (14.9%) 63 (5.1%) 1170 (94.9%)
4 791 379 963 1.2 631 (79.8%) 121 (15.3%) 39 (4.9%) 752 (95.1%)
5 478 274 560 1.2 393 (82.2%) 58 (12.1%) 27 (5/7%) 451 (94.3%)
6 273 178 329 1.2 208 (76.2%) 42 (15.4%) 23 (8.4%) 250 (91.6%)
7 160 90 191 1.2 126 (78.8%) 23 (14.4%) 11 (6.8%) 149 (93.2%)
8 86 63 107 1.2 63 (73.3%) 15 (17.4%) 8 (9.3%) 78 (90.7%)
9 46 32 48 1 44 (95.7%) 2 (4.3%) 0 (0%) 46 (100.0%)
10 22 24 24 1.1 19 (86.4%) 2 (9.1%) 1 (4.5%) 21 (95.5%)
11 12 9 14 1.2 9 (75.0%) 2 (16.7%) 1 (8.3%) 11 (91.7%)
12 6 5 7 1.2 4 (66.7%) 1 (16.7%) 1 (6.6%) 5 (83.4%)
13 3 2 4 1.3 2 (66.7%) 1 (33.3%) 0 (0%) 3 (100.0%)
14 2 1 2 1 2 (100.0%) 0 (0%) 0 (0%) 2 (100.0%)
15 1 1 1 1 1 (100.0%) 0 (0%) 0 (0%) 1 (100.0%)
16 1 0 1 1 1 (100.0%) 1 (100.0%) 0 (0%) 1 (100.0%)
Total 14,086 4833 16,778 3 11,303 (80.2%) 1975 (14.02%) 808 (5.7%) 13,278 (94.3%)
  1. N number of patients, Pt patients, Tx treatment