Economic burden of age-related macular degeneration in routine clinical practice: the RAMDEBURS study

Fecha de publicación: 01/10/2021 Fecha Ahead of Print: 01/06/2021

Autores de IIS La Fe

• Patricia Udaondo Mirete

  Autor

Participantes ajenos a IIS La Fe

• Ruiz-Moreno, JM
• Arias, L
• Abraldes, MJ
• Montero, J

Grupos

• Biomedicina Molecular, Celular y Genómica

  

  Leader

  José María Millán Salvador

Abstract

Purpose To describe and evaluate the main direct health costs, in routine clinical practice, of age-related macular degeneration (AMD) patients, from hospital perspective, in Spain. Methods Retrospective, 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 euro5,386,511.0, with a mean cost per patient of euro4627.6 +/- 2383.9. The largest cost items were diagnostic examinations (euro2.832.902,0) and vascular endothelial growth factor inhibitors (anti-VEGF) treatment (euro2.038.257,2). 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). Conclusions AMD was associated with considerable healthcare costs for regional healthcare systems. Diagnostic examinations, particularly OCT examinations, and anti-VEGF treatment represented the largest cost items.

Keywords

• Age-related macular degeneration; Health economics; Economic burden; Vascular endothelial growth factor inhibitors; VEGF