Costs of Newly Diagnosed Neovascular Age-Related Macular Degeneration Among Medicare Beneficiaries, 2004–2008

Qualls, Laura G.; Hammill, Bradley G.; Wang, Fang; Lad, Eleonora M.; Cousins, Scott W.; Curtis, Lesley H.

doi:10.1097/iae.0b013e31826f065e

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Our review identified 13 studies that reported on the costs associated with the introduction of anti-VEGF treatments for the treatment of nAMD [41][42][43][44][45][46][47][48][49][50][51][52][53].…”

Section: Impact On Costsmentioning

confidence: 99%

Anti-vascular endothelial growth factor in neovascular age-related macular degeneration – a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems

et al. 2020

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Background Systematically review the evidence describing the impact of anti–vascular endothelial growth factor (anti-VEGF) therapy on neovascular age-related macular degeneration (nAMD) patient outcomes and healthcare resource utilization. Methods A systematic literature review was completed using Medline and EMBASE for publications prior to July 2018, and proceedings from major ophthalmology conferences (January 2016 to July 2018). The search strategy combined terms for nAMD with terms for anti-VEGF and study design. The review focused on publications describing the impact of anti-VEGF on blindness, visual impairment, vision-related quality of life (VRQoL), mortality, and costs. The search targeted data collected in epidemiological or observational studies to reflect real-world outcomes but also considered modeling-based approaches. Results The use of anti-VEGF in clinical practice was associated with significant reduction in the incidence of blindness by nAMD. Population-based analyses reported reduction in incidence among the general population of 47% (9.1 cases/100,000 in 2006 to 4.8 cases/100,000 in 2011). Among patients aged ≥50 years, a reduction of 50% was observed (52.2 cases/100,000 in 2000 to 25.7 cases/100,000 in 2010). In some cases, the odds of decreased vision (defined as decline from normal to moderate, moderate to severe, or severe to blindness) fell by 41% following introduction of anti-VEGF. Patients’ VRQoL improved with treatment, with patients reporting a positive impact shortly after treatment was initiated. Change on National Eye Institute 25-Item Visual Function Questionnaire score from baseline to month 12 ranged from 0.7 to 4.4. Although nAMD patients report signs of depression and anxiety, the evidence suggests that there is no association between the use of anti-VEGF and the prevalence or diagnosis of depression. The introduction of anti-VEGF led to increased overall treatment costs due to replacement of existing less frequently administered treatments (e.g. photodynamic therapy) and increased number of patients treated (prior to anti-VEGF, only ~ 20% of patients were eligible for treatment). Conclusions The introduction of anti-VEGF agents has been associated with a positive impact on patient-relevant outcomes, including a significant reduction in incidence of blindness and visual impairment by nAMD. Anti-VEGF agents replaced less-effective treatments, improving patient outcomes and broadening the patient population eligible for treatment.

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Section: Impact On Costsmentioning

confidence: 99%

Anti-vascular endothelial growth factor in neovascular age-related macular degeneration – a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems

et al. 2020

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“… 5 6 The ongoing nature of treatment for neovascular AMD has profound cost implications to patients and to society, reflected in the recent retrospective observational study that demonstrated that new cases of neovascular AMD were associated with substantial discrepancies in total medical costs (41% higher compared with non-neovascular AMD controls). 7 The cost implications for neovascular AMD treatment are, however, balanced against savings associated with this treatment (improvement in visual acuity and reduction in cases of legal blindness). 8 Patients with untreated or untreatable advanced AMD invariably suffer from impairment of central vision, with consequential loss of social independence as a result of a concomitant inability to read, recognise faces, watch television or drive.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of age-related macular degeneration in the Republic of Ireland

et al. 2015

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BackgroundAge-related macular degeneration (AMD) remains the most common cause of visual loss among subjects over 50 years of age in the developed world. The Irish Longitudinal study on Ageing (TILDA) is a population-based study of subjects aged 50 years or older, designed to investigate factors that influence ageing, and has enabled this investigation of the prevalence of AMD in the Republic of Ireland (ROI).MethodsData collected from a nationally representative sample of community-living older adults aged 50 years and over in ROI over the period November 2009 to July 2011. 5035 participants attended the TILDA health centre for assessment. Retinal photographs were obtained in 4859 of these participants. Retinal grading was performed in a masked fashion using a modified version of the International Classification and Grading System for AMD.ResultsAdjusting for lower response rates among older subjects, the estimated overall prevalence of any AMD was 7.2% (95% CI 6.5% to 7.9%) in the population aged 50 years or older. The estimated prevalence of early AMD was 6.6% (95% CI 5.9% to 7.3%), and the estimated prevalence of late AMD was 0.6% (95% CI 0.4% to 0.8%). Statistically significant associations with AMD included increasing age and family history of the condition.ConclusionsThis is the first study to provide prevalence estimates of AMD in ROI and will inform eye care professionals and policymakers involved in the delivery and planning of care for those afflicted with this condition.

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“…The 1-year cost increase for AF was high, even relative to the 1-year cost of other known costly conditions such as heart failure, estimated at an incremental US$12,924 in 2006 dollars (US$14,423 in 2009 dollars) in the CHS 26 or macular degeneration (US$5197 in 2009 dollars); 27 but the total hospital and clinical costs were still higher among participants dying of or surviving with prostate cancer 28 (US$45,053 in 2009 dollars in medical costs, compared to US$25,675 in the year post-AF diagnosis).…”

Section: Discussionmentioning

confidence: 99%

Hospital and clinical care costs associated with atrial fibrillation for Medicare beneficiaries in the Cardiovascular Health Study and the Framingham Heart Study

et al. 2018

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Background:Atrial fibrillation is increasingly prevalent as the US population ages and is associated with significant morbidity and mortality. Care for patients with atrial fibrillation can be costly, US health care costs are comparatively high, and there are few cost estimates available that incorporate detailed measurement of comorbidities and their effects on costs.Methods and Results:In the Cardiovascular Health Study and the Framingham Heart Study, participants aged 65 years or older with newly diagnosed atrial fibrillation were matched on age and follow-up time to referents free of atrial fibrillation. The total clinical and hospital medical costs paid by Medicare Parts A and B (drug costs from Medicare Part D costs were not included) in the year prior to diagnosis (or matching) were compared with costs in the following year. Estimates were adjusted for other medical conditions and adjusted to 2009 dollars. In the Cardiovascular Health Study, 513 participants were diagnosed with new-onset atrial fibrillation and survived 30 days post-atrial fibrillation diagnosis, and 513 referents (as a control cohort) were identified, with a mean age of 77 years. In the Framingham Heart Study, we identified 336 participants diagnosed with atrial fibrillation, who survived 30 days post-atrial fibrillation diagnosis and matched these participants to 336 referents. We compared these new-onset atrial fibrillation participants with referents, using a difference in difference design to account for both time trends and differences between the two groups. The adjusted incremental cost for participants with atrial fibrillation, compared with referents, was US$18,060 (95% confidence interval: US$14,965–US$21,155) in the Cardiovascular Health Study and US$20,012 (95% confidence interval: US$15,057–US$24,966) in the Framingham Heart Study. The pooled estimate was US$18,601 (95% confidence interval: US$15,981–US$21,234).Conclusion:Atrial fibrillation was associated with increased costs in the year after diagnosis in two community-based cohorts, even after careful accounting for age, time period, and systematically measured comorbidities.

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Costs of Newly Diagnosed Neovascular Age-Related Macular Degeneration Among Medicare Beneficiaries, 2004–2008

Abstract: Newly diagnosed neovascular age-related macular degeneration was associated with a substantial increase in total medical costs. Costs increased over time, reflecting growing use of anti-vascular endothelial growth factor therapies.

Cited by 15 publications

References 26 publications

Anti-vascular endothelial growth factor in neovascular age-related macular degeneration – a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems

Anti-vascular endothelial growth factor in neovascular age-related macular degeneration – a systematic review of the impact of anti-VEGF on patient outcomes and healthcare systems

Prevalence of age-related macular degeneration in the Republic of Ireland

Hospital and clinical care costs associated with atrial fibrillation for Medicare beneficiaries in the Cardiovascular Health Study and the Framingham Heart Study

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