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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