Abstract
PurposeTo describe and evaluate the main direct health costs, in routine clinical practice, of age-related macular degeneration (AMD) patients, from hospital perspective, in Spain.MethodsRetrospective, 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).ConclusionsAMD was associated with considerable healthcare costs for regional healthcare systems. Diagnostic examinations, particularly OCT examinations, and anti-VEGF treatment represented the largest cost items.
Highlights
IntroductionAge-related macular degeneration (AMD) is a prevalent, chronic, and progressive retinal degenerative disease of the macula [1, 2]
Age-related macular degeneration (AMD) is a prevalent, chronic, and progressive retinal degenerative disease of the macula [1, 2].AMD constitutes one of the leading causes of severe and irreversible visual impairment globally, but most notably in developed countries, among the elderly [3,4,5,6,7,8,9]
This study aimed to describe and evaluate the main direct health costs, in routine clinical practice, of AMD patients, from hospital perspective, in Spain
Summary
Age-related macular degeneration (AMD) is a prevalent, chronic, and progressive retinal degenerative disease of the macula [1, 2]. AMD constitutes one of the leading causes of severe and irreversible visual impairment globally, but most notably in developed countries, among the elderly [3,4,5,6,7,8,9]. The results of a metaanalysis that included 129,664 subjects showed that the prevalence of AMD ranged from 7.3% in Asian population to 12.3% in European ancestry population [5]. As the life expectancy is rising up, the importance of AMD increases [10]. It was estimated that the number of people with the disease would be around 196 million in 2020, increasing to 288 million in 2040 [5]
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