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. 2019 Nov 12;19(1):828.
doi: 10.1186/s12913-019-4666-0.

Incremental economic burden associated with exudative age-related macular degeneration: a population-based study

Siin Kim  1 , Sang Jun Park  2 , Seong Jun Byun  3   4 , Kyu Hyung Park  3 , Hae Sun Suh  5
Affiliations

Incremental economic burden associated with exudative age-related macular degeneration: a population-based study

Siin Kim et al. BMC Health Serv Res. .

Abstract

Background: 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. 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.

Methods: This 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.

Results: A 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).

Conclusions: Exudative 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.

Keywords: Age-related macular degeneration; Cost of illness; Exudative AMD; Incremental cost; Macular degeneration; Models, econometric; Propensity score; Ranibizumab.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Sample selection flow. AMD, age-related macular degeneration; DB, database; NHIS, National Health Insurance Service. aCandidates for the non-AMD group were preliminarily matched to the exudative AMD group in a 1:10 to 1:20 ratio by age group and date of healthcare facility visits
Fig. 2
Fig. 2
a Descriptive analysis of annual healthcare resource utilization during a 1-year follow-up period. b Descriptive analysis of annual healthcare costs during a 1-year follow-up period. AMD, age-related macular degeneration; USD, United States Dollar
See this image and copyright information in PMC

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