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Observational Study
. 2021 Oct;41(10):3427-3436.
doi: 10.1007/s10792-021-01906-x. Epub 2021 Jun 10.

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

José M Ruiz-Moreno  1   2   3   4 , Luís Arias  5 , Maximino J Abraldes  6 , Javier Montero  7 , Patricia Udaondo  8 ; RAMDEBURS study group
Affiliations
Observational Study

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

José M Ruiz-Moreno et al. Int Ophthalmol. 2021 Oct.

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 €5,386,511.0, with a mean cost per patient of €4627.6 ± 2383.9. The largest cost items were diagnostic examinations (€2.832.902,0) and vascular endothelial growth factor inhibitors (anti-VEGF) treatment (€2.038.257,2). 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; Economic burden; Health economics; VEGF; Vascular endothelial growth factor inhibitors.

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Conflict of interest statement

Dr Ruiz-Moreno has received a grant from Allergan during the conduct of the study. None of the co-authors have any conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Number of intravitreal injections according to the vascular endothelial growth factor inhibitor administered
Fig. 3
Fig. 3
Overview of costs distribution among the different items (%)
See this image and copyright information in PMC

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