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. 2014:2014:939315.
doi: 10.1155/2014/939315. Epub 2014 Mar 26.

Costs and Quality of Life in Diabetic Macular Edema: Canadian Burden of Diabetic Macular Edema Observational Study (C-REALITY)

John R Gonder  1 , Valery M Walker  2 , Martin Barbeau  3 , Nancy Zaour  3 , Bryan H Zachau  2 , James R Hartje  2 , Ruihong Li  3
Affiliations

Costs and Quality of Life in Diabetic Macular Edema: Canadian Burden of Diabetic Macular Edema Observational Study (C-REALITY)

John R Gonder et al. J Ophthalmol. 2014.

Abstract

Purpose. To characterize the economic and quality of life burden of diabetic macular edema (DME) in Canadian patients. Patients and Methods. 145 patients with DME were followed for 6 months with monthly telephone interviews and medical chart reviews at months 0, 3, and 6. Visual acuity in the worst-seeing eye was assessed at months 0 and 6. DME-related healthcare costs were determined over 6 months, and vision-related (National Eye Institute Visual Functioning Questionnaire) and generic (EQ-5D) quality of life was assessed at months 0, 3, and 6. Results. Mean age of patients was 63.7 years: 52% were male and 72% had bilateral DME. At baseline, visual acuity was categorized as normal/mild loss for 63.4% of patients, moderate loss for 10.4%, and severe loss/nearly blind for 26.2%. Mean 6-month DME-related costs/patient were as follows: all patients (n = 135), $2,092; normal/mild loss (n = 88), $1,776; moderate loss (n = 13), $1,845; and severe loss/nearly blind (n = 34), $3,007. Composite scores for vision-related quality of life declined with increasing visual acuity loss; generic quality of life scores were highest for moderate loss and lowest for severe loss/nearly blind. Conclusions. DME-related costs in the Canadian healthcare system are substantial. Costs increased and vision-related quality of life declined with increasing visual acuity severity.

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Figures

Figure 1
Figure 1
Mean 6-month DME-related costs per patient by visual acuity severity: with and without drug costs.
Figure 2
Figure 2
Mean NEI VFQ-25 scores at 6 months by visual acuity level. *Mean of general vision, near activities, distance activities, peripheral vision, and colour vision subscales. **Mean of driving, ocular pain, role difficulties, dependency, social functioning, and mental health subscales. VR Qol: vision-related quality of life.
Figure 3
Figure 3
Mean EQ-5D utility scores and 95% confidence intervals at 6 months by visual acuity severity.
Figure 4
Figure 4
Mean EQ-5D visual analogue scale (VAS) scores and 95% confidence intervals at 6 months by visual acuity severity.
See this image and copyright information in PMC

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