But having the injections every four weeks is necessary to control retinal diseases and stop thousands across New Zealand losing their vision prematurely.
That is why University of Otago ophthalmology consultant and Dunedin eye surgeon Dr Francesc March is praising Pharmac for making a long-awaited drug available. It means patients with retinal diseases will only need to have the injections every 12-16 weeks.
He said faricimab (Vabysmo), a drug injection for the retina, was approved for patient use by Medsafe in October 2023, and will be funded by Pharmac from Monday, offering "a meaningful step toward the extended durability of retinal treatments".
The drug could save hundreds of patients around Otago, and about 20,000 nationwide, from losing their vision prematurely, Dr March said.
Retinal diseases such as neovascular age-related macular degeneration (AMD) or diabetic macular oedema (DMO) were managed with anti–vascular endothelial growth factor (anti-VEGF) injections.
The drugs inhibit pathological neovascularisation and reduce vascular permeability, preserving vision for millions of patients worldwide.
"In New Zealand, we have been using Avastin, ranibizumab and aflibercept, which require injections every four weeks to maintain control of the disease; and later on, it can be extended depending on the response to the treatment.
"However, the need for frequent intravitreal injections remains a significant burden for patients and healthcare systems."
He said faricimab had demonstrated improved durability and fluid control compared with earlier drugs and many patients were achieving stable disease on 12-16 week intervals.
"Longer-lasting intravitreal medications have the potential to meaningfully reduce treatment burden in the real world and improve long-term visual outcomes."
Multiple studies had highlighted a substantial proportion of patients with neovascular AMD and diabetic retinopathy experienced delayed or missed appointments in routine practice, often due to logistical challenges, comorbidities, and the cumulative strain of frequent injections, he said.
These issues affected about 10%-30% of patients and were associated with worse anatomical and visual outcomes.
"This drug can decrease the number of required clinic visits, imaging studies and injections, helping relieve pressure on healthcare systems, while improving adherence and patient quality of life," he said.
