Write a 1,000-1,250 word paper that addresses a health issue for older individuals. Include the following: 1. Evaluate what the literature suggests as a resolution to your chosen issue. 2. Discuss any attempts to incorporate the solution into public policy. 3. Determine the barriers to implementation of the solution. 4. Analyze the options being discussed for public and/or private funding. 5. Propose your own recommendation.

Title: Improving Health Care Access for Older Individuals: Addressing the Issue of Age-Related Macular Degeneration (AMD)

Introduction

Age-related macular degeneration (AMD) is a prevalent health issue affecting older individuals, particularly those above the age of 50. This condition progressively affects central vision, resulting in significant visual impairment and potentially leading to blindness. The following paper will evaluate the current literature regarding AMD and propose a resolution to address this health issue affecting older individuals. Additionally, attempts to incorporate potential solutions into public policy will be discussed, along with barriers to implementation and funding options.

1. Literature Evaluation

Research suggests that the use of intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents is an effective resolution to AMD (Chakravarthy et al., 2014). Anti-VEGF treatment aims to inhibit the growth of abnormal blood vessels in the eye, reducing the progression of AMD and preserving visual acuity. Multiple clinical trials have demonstrated the efficacy of anti-VEGF therapy in preventing vision loss and even improving visual acuity in some cases (Brown et al., 2016; Heier et al., 2014). Moreover, evidence suggests that early intervention with anti-VEGF treatment is crucial in achieving optimal outcomes (LUMINOUS Study Group et al., 2017).

2. Public Policy Incorporation

The incorporation of anti-VEGF therapy for AMD into public policy has been a priority in many countries. For instance, in the United States, the Centers for Medicare and Medicaid Services (CMS) have approved the coverage of anti-VEGF agents for certain indications, including AMD (CMS, 2019). This coverage ensures that eligible older individuals have access to these effective treatments without bearing the financial burden themselves. Similarly, other countries with publicly funded healthcare systems, such as the United Kingdom and Canada, have implemented protocols to provide anti-VEGF treatments for AMD within their publicly funded healthcare systems (NICE, 2015; CADTH, 2014).

3. Barriers to Implementation

Despite efforts to incorporate anti-VEGF therapy into public policy, several barriers hinder its full implementation. One major constraint is the high cost of treatment. Anti-VEGF agents are expensive, placing a financial burden on healthcare systems and potentially limiting access for older individuals with limited financial resources. Furthermore, the need for frequent intravitreal injections presents logistical challenges, including limited availability of ophthalmology clinics, difficulties in transportation for older individuals, and the requirement for trained healthcare professionals to administer the injections (Wykoff et al., 2017).

Another challenge is the underdiagnosis and undertreatment of AMD. Many older individuals may not be aware of their deteriorating eyesight or attribute it to normal aging, leading to late diagnosis and missed treatment opportunities. Educating both healthcare professionals and the general public about the importance of screening for AMD and seeking timely intervention is essential to overcome this barrier (Owsley et al., 2014).

4. Funding Options

To ensure sustainable access to anti-VEGF treatments for AMD, various funding options are being discussed. One approach is to negotiate lower prices with pharmaceutical companies to reduce the cost burden on healthcare systems. Additionally, the allocation of research funding towards the development of cost-effective AMD treatments could contribute to long-term affordability. Collaborations between public and private entities, such as pharmaceutical manufacturers and healthcare organizations, can also be explored to fund treatment programs and infrastructure development.

Another potential avenue for funding is through public-private partnerships that leverage philanthropic contributions from foundations and wealthy individuals to support AMD treatment initiatives. Such partnerships have been successful in funding healthcare programs in low- and middle-income countries and could be extended to address AMD treatment disparities among older individuals in resource-constrained settings.

5. Recommendation

Based on the literature evaluation and consideration of the barriers and funding options, a multilevel recommendation is proposed to improve access to anti-VEGF therapies for AMD in older individuals:

a. Enhancing Public Awareness and Screening: Public health campaigns targeting older individuals should be initiated to raise awareness about AMD symptoms, the importance of regular eye examinations, and early intervention. Collaboration with healthcare professionals, community centers, and senior care facilities will be essential to reach the target population effectively.

b. Strengthening Healthcare Infrastructure: Investment in ophthalmology clinics and training programs for healthcare professionals should be prioritized to ensure sufficient capacity for administering intravitreal injections. Telemedicine services can also be leveraged to provide remote consultations and reduce the need for in-person visits, particularly for rural and geographically isolated older individuals.

c. Negotiating Affordable Pricing: Collaboration between government agencies, payers, and pharmaceutical manufacturers should be pursued to negotiate lower prices for anti-VEGF medications, making them more affordable for both healthcare systems and older individuals.

d. Public-Private Partnerships: Engaging philanthropic organizations and private foundations in initiatives to fund AMD treatment programs will facilitate resource mobilization and contribute to sustainable access to anti-VEGF therapies.

Conclusion

Addressing the health issue of AMD among older individuals requires a comprehensive approach that encompasses clinical treatment, public policy, and funding strategies. By evaluating existing literature, incorporating solutions into public policy, identifying barriers to implementation, and analyzing funding options, the proposed recommendation aims to enhance access to anti-VEGF therapies for AMD and improve visual outcomes for older individuals. Implementing these measures will contribute to better health outcomes and quality of life for the aging population.

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