Abstract
BackgroundThe exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages. The objective of this study was to assess the incremental economic burden of exudative AMD by comparing total healthcare costs between the exudative AMD group and non-AMD group to understand economic burden related to exudative AMD.MethodsThis retrospective cohort study used the National Health Insurance Service database including the entire Korean population. Exudative AMD group included individuals with at least one claim for ranibizumab and one claim using the registration code for exudative AMD (V201). Non-AMD group was defined as individuals without any claims regarding the diagnostic code of H35.3 or ranibizumab. The exudative AMD group and non-AMD group were matched using a propensity-score model. Incremental healthcare resource utilization and healthcare costs were measured during a one-year follow-up by employing econometric models: ordinary least squares (OLS) with log transformation and heteroscedastic retransformation; and generalized linear model (GLM) with a log link function and gamma distribution.ResultsA total of 7119 exudative AMD patients were matched to 7119 non-AMD patients. The number of outpatient visits was higher in the exudative AMD group (P-value < 0.0001), while the length of hospitalization was shorter in exudative AMD group (P-value < 0.0001). Exudative AMD patients had total costs 2.13 times (95%CI, 2.08–2.17) greater than non-AMD group using OLS, and total costs 4.06 times (95%CI, 3.82–4.31) greater than non-AMD group using GLM. Annual incremental total costs were estimated as $5519 (OLS) and $3699 (GLM).ConclusionsExudative AMD was associated with significantly increased healthcare costs compared to the non-AMD group. Attention is needed to manage the socioeconomic burden of exudative AMD.
Highlights
The exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages
A total of 7119 individuals were identified as incident exudative AMD patients who met the eligibility criteria; these were matched to 7119 individuals who constituted the non-AMD group (Fig. 1)
Results of the ordinary least squares (OLS) analysis showed that the total healthcare cost was 2.13 times higher in the exudative AMD group relative to the non-AMD group (95% confidence interval [Confidence interval (CI)]; 2.08–2.17) (Table 2)
Summary
The exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages. In Korea, the annual cost of anti-VEGF therapy per patient has increased from $7947 in 2010 to $10,246 in 2014, and the total burden of anti-VEGF therapy in Korean population was expected to continue to increase by the year 2030 [7]. Those studies are limited by several factors, such as the absence of appropriate controls comparable to patients with exudative AMD in demographic and clinical characteristics, possibilities of recall bias resulting from the telephone survey, and a narrow definition of economic burden confined to the treatment costs for exudative AMD. Burden of disease can be used as an evidence for priority in healthcare policies
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