Amniotic Membrane Usage Up Over the Decade, Mostly by ODs for Dry Eye

Medicare costs for AMGs surged from $3.6 million in 2011 to $95.6 million in 2020, with dry eye-related AMG costs increasing from $250,000 to $41.4 million. Photo: Nathan Lighthizer, OD. Click image to enlarge. Amniotic membrane grafts can play a crucial role in the management of certain ocular conditions, including vision-threatening cases of chemical injuries and autoimmune inflammation. Just how commonly used are they? Researchers primarily based at Stanford University analyzed the use patterns and costs associated with sutureless ocular amniotic membrane grafts in the Medicare population from 2011 to 2020.Their study highlighted significant increases in the use and associated costs of amniotic membranes, particularly for treating dry eye conditions, which represented 44% of claims by 2020, up from 7% in 2011. The research revealed that patients were more likely to receive membrane grafts from optometrists than ophthalmologists, suggesting a trend toward ODs being more proactive in prescribing these treatments. Nevertheless, the researchers also noted potential concerns about financial incentives leading to potentially inappropriate use of amniotic membranes, which was demonstrated by the disparity between the costs paid to healthcare providers and the reimbursements received from Medicare.Charges for ocular sutureless amniotic membranes increased from $3.5 million in 2011 to $95.6 million in 2020; charges for amniotic membrane grafts used to treat dry eye increased from $250,000 to $41.4 million over this period. Notably, 28% of all claims for grafts were submitted by 1% of providers.The study noted that patients treated by optometrists were more likely to receive an amniotic membrane at their initial visit with the administering provider, more likely to receive a membrane graft at the time of their diagnosis with dry eye and more likely to receive multiple grafts. Costs of managing the average dry eye patient have increased over time, particularly among providers who use amniotic membranes, and most particularly among optometrists who use them.There is ongoing research into the use of sutureless amniotic membranes for the management of refractory dry eye disease, with evidence that they can improve symptoms compared to other common treatments when employed in appropriate patients.“By more closely aligning tissue reimbursement with the true acquisition costs for sutureless amniotic membrane grafts, policymakers could ensure continued coverage for a medical device with established benefits and encourage ongoing research into its adoption for novel clinical indications, while also limiting the costs associated with inappropriate use of AMGs in situations where they are unlikely to benefit patients,” the researchers proposed in their paper, which was published earlier this week in Ophthalmology.Click here for the journal source. Vail D, Nudleman E, Abdeljaber L, et al. Utilization patterns and costs of ocular amniotic membrane grafts in the Medicare population. Ophthalmology. August 26, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.