Macular Degeneration Treatment Cost: Anti-VEGF Injections, Supplements & Low Vision

AMD affects more than 11 million Americans, according to the National Eye Institute — making it the leading cause of vision loss in adults over 60 in the United States. By 2050, NEI projects that number will double. If you or someone you care for has received this diagnosis, understanding what treatment costs — and what Medicare actually covers — is essential before the first injection appointment.

Here’s the honest breakdown.

Dry AMD: Management Without a Cure

Dry AMD is the more common form, accounting for about 85–90% of all AMD cases. The bad news: there’s currently no approved treatment that stops or reverses it. The good news: most cases progress slowly, and large clinical trials have identified supplements that reduce progression risk.

AREDS2 supplements are the current standard for intermediate or advanced dry AMD in one eye. The formulation includes vitamins C and E, lutein, zeaxanthin, zinc, and copper. AAO Preferred Practice Pattern guidelines recommend AREDS2 supplements specifically for patients with intermediate AMD or advanced AMD in one eye — not for early AMD or as a general preventive for people without AMD.

Monitoring frequency depends on disease stage. Patients with intermediate dry AMD typically need ophthalmology visits every 6–12 months. Advanced dry AMD with geographic atrophy may require 3–6 month intervals.

Wet AMD: The Injection Era Changed Everything

Wet (neovascular) AMD accounts for only 10–15% of AMD cases but causes the majority of severe vision loss. Abnormal blood vessels grow beneath the retina, leaking fluid and blood that rapidly destroy central vision. Without treatment, wet AMD can cause legal blindness within months.

Anti-VEGF injections — which block the vascular endothelial growth factor driving abnormal vessel growth — transformed wet AMD from a near-certain path to blindness into a manageable chronic condition for most patients. The catch: most patients need ongoing injections for years, sometimes indefinitely.

Current Anti-VEGF Options and Their Costs

Eylea (aflibercept) — $1,850 per injection FDA-approved for wet AMD. Approved for 8-week dosing intervals after initial monthly loading doses, reducing injection frequency for many patients. A high-dose version (Eylea HD) is now available for some patients at longer intervals.

Lucentis (ranibizumab) — $1,970 per injection The original FDA-approved anti-VEGF for AMD. Approved at monthly dosing. Branded Lucentis is increasingly being replaced by biosimilars — Byooviz and Cimerli — at lower cost.

Vabysmo (faricimab) — approximately $2,300 per injection The newest option, approved in 2022. Targets both VEGF-A and Ang-2 pathways. Clinical trials showed some patients can extend to 16-week dosing intervals.

Avastin (bevacizumab) — $50–$100 per injection Off-label use of a cancer drug. Multiple large-scale randomized controlled trials, including the NEI-sponsored CATT trial, found Avastin and Lucentis equally effective for AMD. The Comparison of AMD Treatments Trials (CATT) enrolled over 1,200 patients and showed equivalent visual outcomes. Many retinal specialists use Avastin as first-line therapy given its dramatically lower cost, reserving other agents for cases with inadequate response.

What Medicare Part B Actually Pays

Medicare Part B covers physician-administered drugs — including anti-VEGF injections given in an ophthalmologist’s office. Here’s the math:

After your annual Part B deductible ($257 in 2025), Medicare pays 80% of the Medicare-approved amount. For a $1,850 Eylea injection, you’d owe approximately $370 per injection. On a monthly injection schedule, that’s $4,440 per year — just from your 20% share.

Medigap significantly changes this. If you have a Medigap Plan G or Plan F, your supplemental insurance covers that 20% after the deductible, bringing per-injection out-of-pocket cost to near zero for the rest of the year. If you’re on monthly injections and don’t have Medigap, exploring a supplemental policy may save more annually than its premium costs.

For Avastin at $50–$100 per injection, even without Medigap, your 20% share is only $10–$20 per injection. The cost differential between Avastin and branded agents is dramatic from a patient out-of-pocket perspective.

Photodynamic Therapy: Older, Less Common

Photodynamic therapy (PDT) with Visudyne was the standard treatment before anti-VEGF injections. It’s rarely used as first-line therapy today, though it may still be used for certain lesion types — particularly polypoidal choroidal vasculopathy. Cost runs $1,500–$3,000 per session, and it typically requires fewer sessions than ongoing injections. Insurance coverage varies.

Low Vision Aids and Rehabilitation

When AMD has already caused central vision loss, low vision rehabilitation helps patients use their remaining vision more effectively. This isn’t “giving up” — it’s a legitimate and often underutilized treatment component.

Some Medicare Advantage plans include low vision rehabilitation benefits. Original Medicare doesn’t cover low vision aids or most rehabilitation services, but state vocational rehabilitation programs and organizations like the American Foundation for the Blind may provide assistance.

The Bottom Line on AMD Costs

Dry AMD is inexpensive to manage — the main costs are supplements and regular monitoring visits. Wet AMD is expensive before insurance and significantly more manageable with adequate coverage. If you’re on Medicare and getting regular anti-VEGF injections, reviewing your Medigap options could save thousands of dollars annually. And if Avastin is clinically appropriate for your case, the cost difference compared to branded agents is substantial — worth a frank conversation with your retinal specialist.