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. 2025 Aug;14(8):1869-1892.
doi: 10.1007/s40123-025-01180-5. Epub 2025 Jun 28.

The Economic Burden of Anti-Vascular Endothelial Growth Factor on Patients and Caregivers in the UK, Europe, and North America

David Tabano  1 , Arjun Watane  2 , Richard Gale  3   4 , Oliver Cox  5 , Sarah R Hill  6 , Louise Longworth  6 , Yemi Oluboyede  6 , Ayesha Ahmed  7 , Nimesh A Patel  8
Affiliations

The Economic Burden of Anti-Vascular Endothelial Growth Factor on Patients and Caregivers in the UK, Europe, and North America

David Tabano et al. Ophthalmol Ther. 2025 Aug.

Abstract

Introduction: Intravitreal (IVT) injections of anti-vascular endothelial growth factor (VEGF) agents are the standard of care for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). While demonstrated to be effective, these treatments potentially place a significant burden on patients owing to their cost and frequency of treatment visits required for administration. The objective of this study was to investigate the economic burden of treatment on patients with nAMD/DME and their informal caregivers in seven countries.

Methods: Data were collected from patients and caregivers in the USA, UK, Canada, Italy, Spain, Germany, and France using a survey between September and December 2022. Each survey collected data to facilitate calculating economic burden, combining the total financial costs (i.e., direct costs to receive treatment) and productivity losses associated with attending treatment appointments over a 6-month period. Quality of life data were collected using validated instruments.

Results: In total, 194 patients and 194 caregivers reported currently receiving (or caring for someone who receives) anti-VEGF treatment. Across all countries, the modal frequency of anti-VEGF treatment was every 4 weeks, except for patients with DME (every 8 weeks). The largest, mean 6-month economic burden on the pooled population of patients with nAMD/DME was reported in Italy (€1244) and on caregivers it was in the USA (€3069). Economic burden was lower for respondents receiving fewer anti-VEGF injections.

Conclusions: More durable therapies for nAMD/DME would reduce treatment burden and have a sizeable impact financially on patients with nAMD/DME and their caregivers.

Keywords: Age-related macular degeneration; Anti-VEGF; Caregivers; Diabetic macular edema; Economic burden; Patients; nAMD.

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Conflict of interest statement

Declarations. Conflicts of Interest: David Tabano and Ayesha Ahmed are employees of Genentech, Inc. Oliver Cox is an employee of F. Hoffmann-La Roche Ltd. Sarah R. Hill, Louise Longworth, and Yemi Oluboyede received funding from F. Hoffmann-La Roche Ltd. to conduct the research presented in this manuscript. Nimesh A. Patel is an advisor for Alcon, Allergan Dorc, Alimera, Eye Point, and Genentech. Richard Gale is a consultant for Abbvie, Apellis, Bayer, Biogen, Boehringer Ingelhiem, Novartis, and Roche. Arjun Watane has no financial disclosures to declare. Since the completion of this manuscript, Louise Longworth has changed affiliations and is now affiliated with Arrow Health Economics. Ethical Approval: These study materials were ethically reviewed by an independent research ethics expert under the auspices of the Association of Research Managers and Administrators (ARMA), who provided a “favorable ethics opinion” for the study. This study involved data collection from participants across multiple countries; however, all data were collected online via recruitment from a central patient panel, and no collaborative institutions were involved in this study to necessitate institution-specific ethical approval. All participants provided informed consent to participate in the study prior to completing the survey. The study did not collect identifiable personal information; therefore, specific consent for publication of identifiable data was not applicable. However, participants consented to the publication of the anonymized study results for research purposes. The study was conducted in accordance with the ethical principles set forth in the Declaration of Helsinki (1964) and its later amendments.

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