Retinal patients fear fee dispute will leave them paying upfront

Every four weeks, 45-year-old Christina Watts visits her retinal specialist to receive an eye injection, a treatment she says has helped slow her vision loss. 

The Prince George, B.C., resident was diagnosed with wet age-related macular degeneration (wet AMD) — a chronic eye disease that causes blurred vision or a blind spot — in January. 

“I have a big round circle [in my left eye]…a grey mass in the centre,” she told CBC News. “It feels like you’re trying to clean your glasses and you can’t get it off.”

Thanks to B.C.’s retinal diseases treatment program, which covers the cost of her monthly injections, her vision has stabilized a little, Watts says.

“Since I’ve been getting the injections, [it has] cleared the grey mass so that I can see colour,” she said.

The program provides free treatment and drugs for more than 20,000 patients diagnosed with wet AMD, a leading cause of blindness among seniors, and other retinal diseases. 

But she is concerned about the future of the program. Last month, she and many patients like her received a letter from the Association of B.C. Retinal Specialists saying it is withdrawing from the program on March 31 following a proposed cut in compensation. 

“With inflation, the rising costs of facilities, equipment, supplies and staffing, it is simply not sustainable … to continue to participate in the program under these circumstances,” the letter reads.

If it were to end, patients would have to pay upfront for the treatment, which costs about $1,700 per visit, and then seek reimbursement from the province.

“I would rather just give up my eye and pay for my kids’ post-secondary education,” Watts said.

B.C. Health Minister Adrian Dix says the program will continue without any disruption.

“[The] program is going to be maintained. It’s an important program and people…are going to continue to get the care they need,” he said during an interview with CBC’s Daybreak North. 

In a statement to CBC News, the Provincial Health Services Authority (PHSA), which administers the program, also said “coverage for the drugs currently made available under the program will not end.”

Retinal specialists calling to withdraw fee cuts

Dix says the changes to compensation came at the request of the B.C. Society of Eye Physicians and Surgeons, which represents a large number of ophthalmologists in the province.

In response, the Association of B.C. Retinal Specialists, a subspecialty of ophthalmology, has filed a petition in B.C. Supreme Court alleging the society’s proposed fee changes are “unfair, prejudicial and oppressive.”

The retinal specialists, according to the petition, say the society is trying to punish a small group of professionals for earning too much from the retinal disease treatment program. 

In a statement to CBC News, the society denied those allegations and said they will be responding through the court process.

The petition claims the fee changes were proposed to redistribute and equalize funds among ophthalmologists. 

Retinal specialists are among the most highly paid doctors in B.C. According to the Medical Service Commission’s financial statement for 2022-23, a majority of the specialists registered in the program billed more than $1 million — and some up to $4.4 million — that fiscal year, compared to a vast majority of doctors in B.C. who billed under $500,000. 

Retinal specialists say they will no longer participate in the program unless the proposed cuts are withdrawn. 

Dix said the province will be working with both groups to find a solution soon. 

PHSA said there will be some changes to how the program is managed following the retinal specialists’ withdrawal.

In the meantime, Watts says she is uncertain what care will look like come April. 

“If the retina specialists aren’t in the treatment program, then who is?” she asked.

“We’re in for vital care and this squabbling is not helping anything.”