Direct medical costs of age-related macular degeneration in Italian hospital ophthalmology departments

Garattini, Livio; Castelnuovo, Emanuela; Lanzetta, Paolo; Viscarra, Cecilia; Ricci, Elena; Parazzini, Fabio

doi:10.1007/s10198-003-0198-x

Cited by 12 publications

(2 citation statements)

References 18 publications

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“…15 Similar to our findings, in an Italian observational trial in patients with any type of AMD (conducted between September 1998 and December 1999), hospital costs and diagnostics were the main drivers of costs. 43 However, the total mean cost per patient per year of €148 for the small subgroup of patients with GA (78/476 patients) was substantially lower than the costs reported herein, possibly reflecting changes in management of patients with GA since the Italian study was conducted.…”

Section: Discussioncontrasting

confidence: 59%

<p>Burden of Illness in Geographic Atrophy: A Study of Vision-Related Quality of Life and Health Care Resource Use</p>

Patel¹,

Ziemssen²,

Ng³

et al. 2020

OPTH

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Purpose: To gain comprehensive information on the burden of illness due to geographic atrophy (GA). Methods: This cross-sectional study with a retrospective chart review involved patients aged ≥70 years with physician-confirmed bilateral symptomatic GA due to age-related macular degeneration (GA group), as well as patients of similar age with no ophthalmic condition that in the opinion of the investigator affected visual function (non-GA group). Data relating to patients' current disease status and sociodemographics were self-reported on patient questionnaires at study entry and extracted from patient charts. Historical data on health care resource utilization (HCRU) were also collected via patient questionnaires and retrospective chart review (GA group only). Overall vision-related functioning and quality of life (QoL) were compared between the GA and non-GA groups using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) composite and subscales, and change in vision over the past year was assessed using the Global Rating of Change Scale. Results: Vision-related functioning and QoL were poorer in patients with vs without GA (n=137 vs 52), as demonstrated by significantly lower NEI-VFQ-25 composite score (mean, 53.1 vs 84.5 points, respectively; P<0.001), as well as lower subscale scores for near activities, distance activities, dependency, driving, social functioning, mental health, role difficulties, color vision, and peripheral vision. Substantially more patients with GA than without GA reported worsening in vision over the past year (82% vs 25%, respectively; odds ratio, 13.55; P<0.001). In the GA group, associated mean annual costs for direct ophthalmological resource use per patient amounted to €1772 (mostly for tests/procedures), and for indirect ophthalmological resource use, €410 (mostly for general practitioner visits). Conclusion: Patients with GA experience a poorer level of vision-related function and QoL than their peers, especially in relation to driving. GA is also associated with notable HCRU/ associated costs, mostly direct costs attributed to diagnostic tests/procedures.

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Section: Discussioncontrasting

confidence: 59%

<p>Burden of Illness in Geographic Atrophy: A Study of Vision-Related Quality of Life and Health Care Resource Use</p>

Patel¹,

Ziemssen²,

Ng³

et al. 2020

OPTH

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“…12,17 Its common occurrence in young adults of working age (50 years of age or less) is even more relevant because its high incidence of recurrence, potential for scarring and permanent visual disability may damage a patient's employment prospects, cause signi cant loss of personal revenue, disrupt the patient's family dynamics, and worsen his or her quality of life. 12,13,[18][19][20] The current study describes the long-term visual outcome, response to anti-VEGF treatment, and rate of disease recurrence over time in a group of patients with AS-CNV. Moreover, the risk of recurrence was calculated according to qualitative analysis of CNV lesions by OCT and OCTA, and the ndings were compared against those of a group of patients who were long believed to exhibit a similar evolution and response to treatment (mCNV).…”

Section: Discussionmentioning

confidence: 99%

Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Velez-Montoya,

Osorio-Landa,

Franco-Ramirez

et al. 2024

Preprint

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Background: To report the risk of exudation recurrence and long-term outcomes in patients with choroidal neovascularization secondary to angioid streaks, according to its morphology and characteristics by optical coherence tomography angiography. Methods: Retrospective analysis of electronic medical records from three hospitals. We enrolled patients with a clinical diagnosis of angioid streaks choroidal neovascularization that had a minimum follow-up of 12 months. From each record, we extracted general demographic data, best corrected visual acuity (baseline, before and after each disease recurrence and last on file), type of treatment, time between last intravitreal injection and disease recurrence, and classification of the neovascular lesion morphology by optical coherence tomography, and optical coherence tomography angiography. Patients with myopic choroidal neovascularization were used as controls. Interobserver agreement was assessed with a Cohen-Kappa test. The Odds ratio was calculated with a chi2 test for significance. Visual acuity change through time was assessed with an ANOVA for repeated measurements with an alpha value of 0.05 for statistical significance. Results: We enrolled 30 patients in the study group and 14 in the control group. In the study group, the baseline and final BCVA was 0.861 ± 0.59 and 1.095 ± 0.61 logMAR (p=0.1). Control group: 1.045 ± 0.57 and 0.617 ± 0.53 logMAR (p<0.05). In the study group, the predominant CNV type by OCTA was mixed (37%), and interlacing (57%) in the control group. Mixed and cog-wheel patterns at baseline had increased Odds for recurrence in the study group (1.2 to 7.4) although it was not significant. Patients in the study group required fewer intravitreal injections on each recurrence episode to achieve disease control (3.5±1.5 vs.1.4±0.2, p<0.01). Conclusions: The benefits of anti-VEGF treatment are lost over time in patients with angioid streaks and CNV. Lesion characteristics by optical coherence tomography angiography could help physicians predict the risk of recurrence. Trial Registration:Retrospective registered, and IRB approved.

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Global Burden of Dry Age-Related Macular Degeneration: A Targeted Literature Review

Schultz

Bhardwaj

Barclay

et al. 2021

Clinical Therapeutics

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Purpose: Age-related macular degeneration (AMD) is a leading cause of blindness, particularly in higherincome countries. Although dry AMD accounts for 85% to 90% of AMD cases, a comprehensive understanding of the global dry AMD burden is needed.Methods: A targeted literature review was conducted in PubMed, MEDLINE, Embase, and the Cochrane Database of Systematic Reviews (1995Reviews ( -2019 to identify data on the epidemiology, management, and humanistic and economic burden of dry AMD in adults. A landscape analysis of patientreported outcome (PRO) instruments in AMD was also conducted via searches in PubMed (1995PubMed ( -2019, ClinicalTrials.gov, PROQOLID, PROLABELS, and health technology assessment reports (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018).Findings: Thirty-seven of 4205 identified publications were included in the review. Dry AMD prevalence was 0.44% globally, varied across ethnic groups, and increased with age. Patients with dry AMD had higher risks of all-cause mortality (hazard ratio [HR] = 1.46; 95% CI, 0.99-2.16) and tobacco-related (HR = 2.86; 95% CI, 1.15-7.09) or cancer deaths (HR = 3.37; 95% CI, 1.56-7.29; P = 0.002) than those without dry AMD. Smoking, increasing age or cholesterol levels, and obesity are key risk factors for developing dry AMD. No treatment guidelines were identified for dry AMD specifically; management focuses on risk factor reduction and use of dietary supplements. In the United States and Italy, direct medical costs and health care resource utilization were lower in patients with dry versus wet AMD. Patients with dry AMD, particularly advanced disease, experienced significant visual function impairment. Dry AMD symptoms included reduced central vision, decreased ability to see at night, increased visual blurriness, distortion of straight lines and text, and faded color vision. Most PRO instruments used in AMD evaluations covered few, if any, of the identified symptoms reported by patients with dry AMD. Although the Quality of Life and Vision Function Questionnaire, 25-item National Eye Institute Vision Function Questionnaire, Low Vision Quality of Life, Impact of Vision Impairment-Very Low Vision, and Functional Reading Independence Index had strong content validity and psychometric properties in patients with dry AMD, they retained limited coverage of salient concepts.Implications: Despite dry AMD accounting for most AMD cases, there are substantial gaps in the published literature, particularly the humanistic and economic burden of disease and the lack of differentiation among dry, wet, or unspecified dry AMD. The significant burden of illness alludes to a high unmet need for tolerable and effective treatment options, as well as PRO instruments with more coverage of dry AMD symptoms and salient concepts. ( Clin Ther.

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Direct medical costs of age-related macular degeneration in Italian hospital ophthalmology departments

Cited by 12 publications

References 18 publications

<p>Burden of Illness in Geographic Atrophy: A Study of Vision-Related Quality of Life and Health Care Resource Use</p>

<p>Burden of Illness in Geographic Atrophy: A Study of Vision-Related Quality of Life and Health Care Resource Use</p>

Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Global Burden of Dry Age-Related Macular Degeneration: A Targeted Literature Review

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