The epidemiology, economics and quality of life burden of age-related macular degeneration in France, Germany, Italy and the United Kingdom

Abstract

Age-related macular degeneration (AMD) is a major public health issue, but little is known about the economics of the disease. This contribution describes the epidemiology and the economics of AMD in four European countries: France, Germany, Italy and the United Kingdom (UK). We reviewed published information on AMD, including guidelines, official statistics, and local literature and interviewed AMD experts. All available health-related quality of life studies (HRQoL) on AMD were also reviewed. Data collection focused on epidemiology, medical management and resource use (both medical and non-medical items). Prevalence of AMD among persons older than 65 years is 8% and increases with age. There are two forms of the disease: atrophic (80-85% of AMD cases) and exudative, which is characterised by choroidal neovascularisation (CNV; 15-20% of AMD cases). No treatment for the atrophic form is available. Laser photocoagulation is the mainstay of treatment for CNV, although less than 30% of persons with CNV can benefit from it. Photodynamic therapy (PDT), a new treatment for CNV, reduces the risk of vision loss in forms with predominantly visible lesions. Several other new procedures are also under development. Rehabilitation and low-vision aids are useful palliative interventions when there is a residual visual acuity. The yearly budget impact of AMD was found to be between 51.3 and 101.1 million euros in the four countries studied. Information on social services and resource use was scant and little is reported on the impact of AMD on HRQoL. Economic studies of AMD should be conducted in order to assist public health decision making.

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

“…Bonastre et al [19] recently estimated the total burden of AMD in four European countries, including Italy, using secondary data on resource utilization of various treatments for AMD, derived mainly from the literature and from expert opinions.This study reported the cost of the main treatment options for AMD patients with CNV, i.e., laser photocoagulation and PDT. The average typical number of each procedure was based on experts' estimates, and the unit costs were INHS tariffs (Decreto Ministeriale "Prestazioni di assistenza specialistica ambulatoriale erogabili nell'ambito del Servizio Sanitario Nazionale e relative tariffe," 22 July 1996).…”

Progress in defining the molecular biology of age related macular degeneration

“…For the individual, severe visual loss from AMD is equivalent in terms of reduction in quality of life to having severe prostatic cancer with uncontrollable pain (Brown et al 2005). For the nation, the economic burden to the United Kingdom of AMD has been estimated to be as much as 101.1 million Euros (Bonastre et al 2002). AMD has been judged on the basis of a spectrum of measures of patient disability to be the third most disabling disease in the US population after diabetes and cancer (SST 2004;Brody et al 2001;Rovner et al 2002;Royal College of Ophthalmologists 2002).…”

The Relationship Between Plasma Concentrations of Lutein and Zeaxanthin with Self-Reported and Actual Prevalence of AMD in an Irish Population-Based Sample

“…7 The loss of central vision in patients afflicted with AMD has a dramatic and adverse impact on their quality of life. 8 For example, the impact of vision loss associated with AMD may result in an inability to drive, to read, to recognize faces, or to watch television, with a consequential loss of social independence and increasing need for family support, 9 which is a major concern in the context of an advancing population. The financial burden of vision loss and/or impairment may be classed as direct or indirect.…”