Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005:103:173-84; discussion 184-6.

The burden of age-related macular degeneration: a value-based medicine analysis

Gary C Brown  1 , Melissa M Brown, Sanjay Sharma, Joshua D Stein, Zachary Roth, Joseph Campanella, George R Beauchamp
Affiliations

The burden of age-related macular degeneration: a value-based medicine analysis

Gary C Brown et al. Trans Am Ophthalmol Soc. 2005.

Abstract

Purpose: To assess the quality-of-life loss and the macroeconomic financial consequences associated with age-related macular degeneration (ARMD).

Methods: Time tradeoff utility analysis was performed to assess the quality-of-life diminution caused by ARMD (both dry and neovascular) in cohorts consisting of (1) patients with ARMD, (2) ophthalmologists asked to assume they had various degrees of severity of ARMD, (3) healthcare providers asked to assume they had various degrees of severity of ARMD, and (4) participants from the general community asked to assume they had various degrees of severity of ARMD. ARMD was classified according to vision in the better-seeing eye as (1) mild: 20/20 to 20/40, (2) moderate: 20/50 to 20/100, (3) severe: < or = 20/200, or (4) very severe: < or = 20/800.

Results: Mild ARMD caused a 17% decrement in the quality of life of the average patient, similar to that encountered with moderate cardiac angina or symptomatic human immunodeficiency virus syndrome. Moderate ARMD caused a 32% decrease in the average patient's quality of life, similar to that associated with severe cardiac angina or a fractured hip. Severe ARMD caused a 53% decrease in quality, more than that of dialysis, and very severe ARMD caused a 60% decrease in the average ARMD patient's quality of life, similar to that encountered with end-stage prostate cancer or a catastrophic stroke that leaves a person bedridden, incontinent, and requiring constant nursing care. Patients with varying degrees of severity of ARMD were found to have quality-of-life impairment ranging from 96% to 750% greater than that estimated by treating ophthalmologists for the same condition. An economic analysis based upon losses to the gross domestic product suggests that ARMD has approximately a $30 billion annual negative impact. The return on investment is therefore potentially high for both treatment with current ARMD therapies and the research costs invested in the development of new ARMD treatment modalities.

Conclusions: ARMD is a major public health problem that has a devastating effect upon patients and marked adverse financial consequences for the economy.

PubMed Disclaimer

References

    1. Klein R, Klein BEK, Tomany SC, et al. Ten-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology. 2002;109:1767–1779. - PubMed
    1. Brown GC, Brown MM, Sharma S, et al. Utility values associated with age-related macular degeneration. Arch Ophthalmol. 2000;118:47–51. - PubMed
    1. Stein JD, Brown MM, Brown GC, et al. Quality of life with macular degeneration. Perceptions of patients, clinicians and community members. Br J Ophthalmol. 2003;87:8–12. - PMC - PubMed
    1. Brown MM, Brown GC, Sharma S, et al. Health care economic analyses and value-based medicine. Surv Ophthalmol. 2003;48:204–223. - PubMed
    1. Bird AC, Bressler NM, Bressler SM, et al. An international classification and grading system for age-related maculopathy and age-related macular degeneration: the International ARM Epidemiological Study Group. Surv Ophthalmol. 1995;39:367–374. - PubMed

Publication types