Advisory/ Clarification on use of Intravitreal Injection: ECHS Order dated 05.06.2024
Central Organisation ECHS
Adjutant General’s Branch
Integrated HQ of MoD (Army)
Thimayya Marg,
Near Gopinath Circle
New Delhi- 110 010
B/49778/AG/ECHS/Claims/Advisory
05 Jun 2024
All Regional Centres
AMA ECHS, Embassy of India, Nepal
ADVISORY/ CLARIFICATION ON USE OF INTRAVITREAL INJECTIONS
1. Ref the following:-
(a) RC ECHS letter No ECHS/RC/Jal/4030/Med/Hosp Gen dt 10 May 2024.
(b) This HQ letter No B/49762/AG/ECHS/2022(i) dt 20 Jun 2022 (copy att).
(c) This HQ Advisory letter No B/49761/AG/ECHS dt 09 Aug 20218 (copy att).
2. Intravitreal injection is a specialized treatment where Anti VEGF (Anti Vascular endothelial growth factors) are injected into the eye in case of macular degeneration, retinopathy or choroidal neovascularisation Needless to say, only vitreo-retinal Surgeons have the requisite expertise to decide on the condition where the cost effective usage of these injections are justified.
3. There have been multiple complaints of indiscriminate usage of these injections by emp hospitals and it is difficult to verify its actual usage or effect unless some improvement is observed which needs validation from a vitreo-retinal surgeon.
4. The following measures are to be implemented for preventing misuse and usage of spurious injectables which may be detrimental to the health of our ESM/dependant:-
(a) BPA to ensure that all claims of Cataract surgery/ administration of Anti-VEGF agents are to be processed in the mandatory basket of JDHS at RCs.
(b) The approval of vitreo-retinal surgeon by email/ opinion on case sheet must be attached for continuation or change of Anti VEGF again after every 3 injections on the basis of supporting documents as per extant policy mentioned at Para 7 of this HQ advisory letter cited at Para 1 (c).
(c) The policy letter regarding waiver of Appx ‘A’ for listed procedures is applicable once the criteria laid down in the preceding Para 4 (b) above is met.
(Rajesh Batish)
Surg Capt
OIC Claims
for MD ECHS
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