Dr. Jane Barratt
Secretary General, International Federation on Ageing
Dr. Geoff Williams
Director & Co-Founder, Calgary Retina Consultants
Canadians have been avoiding non-essential outings, as they should, but it hasn’t always been clear what that means for our health-related appointments for non-COVID-19 concerns like vision health.
“During this pandemic, we’re all being told to keep healthy, stay safe, and protect ourselves and our loved ones,” says Dr. Jane Barratt, Secretary General of the International Federation on Ageing (IFA). “Part of that, particularly if we have an eye condition, is keeping up with our routine screening as much as is possible in this environment.”
For vision especially, it doesn’t make sense to put off assessment or treatment if you think your eyesight may be at risk. “The critical thing is that people who have age-related macular degeneration or diabetic eye disease know that their treatment is time-sensitive,” says Dr. Barratt. “The IFA has every confidence in the safety measures that ophthalmologists have in place and regularly review.”
Treatment options expanding as policy adapts
Though it has sometimes felt like the world’s standing still over the last year, medical research and policy remain fast-moving. The advent of biologic therapies revolutionized treatment for retinal diseases, but now with biosimilars -— which are versions of the originator treatment — entering the market in Canada, conversations about patient choice, safety, and effectiveness must be at the forefront of policy and good practice.
“Retina specialists have been using biologics since 2006 in Canada, so we have 15 years of experience with three different biologics,” says Calgary-based retina specialist Dr. Geoff Williams. “This has provided a good sense of how well they work and how safe they are. Biosimilars, on the other hand, are very new, so it’s going to take some time for doctors to get experience with them and feel comfortable.”
Similar, but not identical
Biosimilars are required to demonstrate similar efficacy to originator biologics, but they aren’t chemically identical. Being newer on the scene, biosimilars have less data available, and most doctors still have very little, if any, experience with them.
One of the big concerns centres around government policy, which will vary between provinces, particularly as it relates to forced switching to biosimilars for patients who are already on an originator biologic treatment. “Biosimilar policy is going to have a direct impact on patients,” says Dr. Williams. “If something is working well for a patient, they generally don’t want to see their treatment change. We’ve seen this pushback already in Alberta with switching to rheumatological biosimilars, with some patients feeling that the biosimilar wasn’t working as well for them.”
The right to decide
More options for treatment are always welcome, but experts want to ensure that having new choices actually results in patients having more choice. “It’s like the COVID-19 vaccine,” says Dr. Barratt. “With five different authorized vaccines becoming available, I know they’re all safe and effective, but I’m still going to want to know which one goes in my arm, and why it was chosen over the others.” The IFA has several resources for patients and the vision community which can be accessed by visiting its website.
As we remind ourselves to make vision a health priority in the midst of the pandemic, it’s important that we inform ourselves about the therapies available and ensure that all voices are being heard in decisions related to treatment choice.
This article was made possible with support from a research-based pharmaceutical company.