Impact of neovascular age-related macular degeneration: burden of patients receiving therapies in Japan

Shigeru Honda,Yirong Chen,Manami Arimoto,Yasuo Yanagi,Satoru Tanaka,Hideki Koizumi,Kota Imai

doi:10.1038/s41598-021-92567-4

Abstract

The chronic eye disorder, neovascular age-related macular degeneration (nAMD), is a common cause of permanent vision impairment and blindness among the elderly in developed countries, including Japan. This study aimed to investigate the disease burden of nAMD patients under treatment, using data from the Japan National Health and Wellness surveys 2009–2014. Out of 147,272 respondents, 100 nAMD patients reported currently receiving treatment. Controls without nAMD were selected by 1:4 propensity score matching. Healthcare Resource Utilisation (HRU), Health-Related Quality of Life (HRQoL), and work productivity loss were compared between the groups. Regarding HRU, nAMD patients had significantly increased number of visits to any healthcare provider (HCP) (13.8 vs. 8.2), ophthalmologist (5.6 vs. 0.8), and other HCP (9.5 vs. 7.1) compared to controls after adjusting for confounding factors. Additionally, nAMD patients had reduced HRQoL and work productivity, i.e., reduced physical component summary (PCS) score (46.3 vs. 47.9), increased absenteeism (18.14% vs. 0.24%), presenteeism (23.89% vs. 12.44%), and total work productivity impairment (33.57% vs. 16.24%). The increased number of ophthalmologist visits were associated with decreased PCS score, increased presenteeism and total work productivity impairment. The current study highlighted substantial burden for nAMD patients, requiring further attention for future healthcare planning and treatment development.

Highlights

The chronic eye disorder, neovascular age-related macular degeneration, is a common cause of permanent vision impairment and blindness among the elderly in developed countries, including Japan
In terms of work productivity and activity impairment (WPAI), the presenteeism was 10.26% higher among currently-treated neovascular age-related macular degeneration (nAMD) patients compared to non-nAMD respondents (21.82% vs. 11.56%) and total work productivity impairment was 10.60% higher (24.58% vs. 13.98%) (Table 2)
As the group of currently-treated nAMD patients experienced a greater number of Healthcare Resource Utilisation (HRU), lower physical component summary (PCS) score, and greater impairment of work productivities, we investigated the association between the number of HRU, especially ophthalmologist visits, and PCS score, as well as the association between HRU and impairment in Scientific Reports | (2021) 11:13152 |

Summary

Introduction

The chronic eye disorder, neovascular age-related macular degeneration (nAMD), is a common cause of permanent vision impairment and blindness among the elderly in developed countries, including Japan. Recent studies have shown improvements in nAMD patients’ vision and vision-related QoL after anti-vascular endothelial growth factor (anti-VEGF) therapy[16,17], which is the standard treatment for nAMD in Japan[18], superseding other available therapies as laser photocoagulation, photodynamic therapy using verteporfin and macular surgery[19] While these previous studies have focused mostly on vision-related QoL and investigating the burden of nAMD in populations of western countries, there is limited research in Japan about the impact of nAMD on HRU, work productivity impairment and Health-Related QoL (HRQoL). The burden of illness was investigated in terms of HRU (6-month self-report), HRQoL and work productivity and activity impairment (WPAI)

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