Economic burden of age-related macular degeneration in routine clinical practice: the RAMDEBURS study

Abstract

Purpose To describe and evaluate the main direct health costs, in routine clinical practice, of age-related macular degeneration (AMD) patients, from hospital perspective, in Spain. Methods Retrospective, multicenter, and observational study conducted on five third-level Spanish hospitals, between December 2018 and December 2019. The study included patients who were diagnosed of AMD before December 2018. Direct healthcare costs were obtained from a Spanish database. Study variables included demographic and clinical variables, and resources, such as treatment, diagnostic tests, medical examination, and surgery. Among the 1414 screened AMD patients, 1164 patients were included. In the overall study patients, the total cost was €5,386,511.0, with a mean cost per patient of €4627.6 ± 2383.9. The largest cost items were diagnostic examinations (€2.832.902,0) and vascular endothelial growth factor inhibitors (anti-VEGF) treatment (€2.038.257,2). Bevacizumab was administered to 325 (27.9%) patients, ranibizumab to 328 (28.2%), and aflibercept to 626 (53.8%); 115 (10.7%) patients received two anti-VEGF treatments, while 90 (7.7%) did not receive any. Over the course of the study, a total of 6,057 anti-VEGF injections were administered, with a mean (95% confidence interval) of 4.8 (4.4–5.2) injections per patient. Regarding safety, 29 patients experience injection-related adverse events, among them 12 patients had cataract and 11 ones elevated intraocular pressure (IOP). The incidence of endophthalmitis was 0.5% (6/1164). Conclusions AMD was associated with considerable healthcare costs for regional healthcare systems. Diagnostic examinations, particularly OCT examinations, and anti-VEGF treatment represented the largest cost items.

The Relationship between Statin and Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

“…Vision loss associated with AMD can induce negative effects on the independence of the elderly and their mental health [ 2 ]. Advanced AMD leads to bilateral blindness, imposes stupendous healthcare costs, and reduces the patients' quality of life as a serious systemic disease [ 1 – 3 ]. AMD is associated with a disorder in the central area of the retina called the macula that, in developing form, can lead to bilateral ocular problems in senile people.…”

Altered Fecal Microbiome and Metabolome in a Mouse Model of Choroidal Neovascularization

“…However, the limitations of anti-VEGF therapy should not be ignored, such as the side effects of the injection (Xi, 2020) and the unsatisfactory duration of the therapeutic effect (Ehlken et al, 2019). In addition, long-term use of anti-VEGF therapy may lead to serious economic burdens, especially in developing countries and regions (Ruiz-Moreno et al, 2021). Therefore, thorough investigation of the mechanisms of nAMD pathogenesis beyond VEGF is urgently needed.…”

Multi-task learning for activity detection in neovascular age-related macular degeneration

“…Also, therapy monitoring using OCT has to take place on up to four-weekly basis in some cases until the end of life. Due to this high frequency of visits, the therapy has put a considerable burden on patients, their families and ophthalmological care since its initial approval in 2006 [14, 2, 43, 51]. Additionally, a future increased need for AMD care has to be expected, since the number of patients suffering from AMD are thought to rise from 196 million in 2020 to 288 million in 2040 [62].…”