Just Too Little Time

Yesterday we had another appointment with my mom’s ophthalmologist. It was her second appointment after having lucentis injection for her AMD (Age-related Macular Degeneration) treatment last month. She took an OCT (Optical Coherence Tomography) test yesterday and the doctor seemed pleased after seeing the result. He said the abnormal blood vessel that blocked her central vision (macula) was significantly reduced.

This is her OCT result before treatment (notice the abnormal blood vessel in the white circle):

This one is her OCT result after treatment:

We have to wait another 4 weeks to see the maximum effectiveness of the treatment. After that he will see if she needs another injection.

AMD is a degenerative condition of the Retina in which the central portion of the Retina, called the Macula, is damaged as a result of the hardening of the small arteries supplying oxygen and nutrients to the Retinal tissue. It is reported as the leading cause of blindness in people over 50 years of age.

When my mom was diagnosed with AMD last month, her ophthalmologist offered two types of drugs for her treatment, lucentis and avastin. Lucentis costs Rp 11 million (US$ 1100) while avastin costs Rp 2 million (US$ 200). The big cost difference between two drugs made us think twice before we decided which type of injection we should choose. The doctor said, “If money is not the problem, use lucentis as it’s already world-wide approved for AMD treatment.” Even though many eye-doctor use avastin as cheaper alternative for AMD treatment, the drug was initially developed (and later approved by FDA) for colon cancer, not for AMD. But he also reminded us that it’s going to be a long run treatment, and he couldn’t tell how many times my mom need the injection. It will depend on the each injection result that will be evaluated every two months.

I wish I could say “money is not the problem”, but sadly, I can’t. Money can become a problem if every two months my mom must have lucentis injection. Though my mom has her own money to support herself, she doesn’t have insurance. For years her medical was paid by my dad’s company, but after my dad died two years ago no more medical support for her. And it was too late for her to apply for new medical insurance at that time as she already 69 years old.

My brother and I can’t help that much either. I don’t know about other families but for us here in Indonesia US$ 1100 is a lot of money, it’s almost a month of my salary. However, after discussing it with my brother we agreed to proceed with lucentis for her first treatment. We just wanted the best for her whenever we could afford. Her doctor said it’s still ok to change to avastin for later treatment “if money finally become the problem”.