Impact de la dégénérescence maculaire néovasculaire : données françaises

Abstract

To assess the impact of bilateral neovascular age-related macula degeneration (NV-AMD) on function and health resource utilization (HRU) in France. Cross-sectional study including 401 NV-AMD patients and 471 controls conducted in five countries in 2006. In both groups, demographic and clinical data were collected and the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), the EuroQoL (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), and questionnaires on HRU were administered. Eighty-seven NV-AMD patients and 92 controls were recruited in France. The mean age of the NV-AMD patients was 79 (range, 65-95), and 64% were female. After adjusting for age, gender, and co-morbidities, compared to controls, NV-AMD patients reported substantially worse vision-related quality of life on the NEI-VFQ (adjusted mean, 44.4 [36.2-52.7] versus 91.8 [86.2-97.5], p<0.0001). HADS anxiety and depression scores were significantly worse in NV-AMD patients (anxiety score, 8.5 [6.3-10.8] versus 5.1 [3.5-6.7] p=0.0005; depression score: 7.1 [5.1-9.1] versus 2.9 [1.5-4.4] p<0.0001). Per patient yearly cost analysis showed significantly higher direct medical costs: 3396 euro versus 85 euro (p<0.0001), and indirect nonmedical-related costs (mainly for assistance with activities of daily living): 2985 euro versus 494 euro (p=0.014). NV-AMD patients in France reported substantially worse QoL and more anxiety and depression symptoms. The functional impact of blindness led to significantly higher health resource utilization in the AMD patients, resulting in higher total health costs compared to a similarly aged control group.