http://www.evrs.eu/medias/2006/congress/Humanistic-Burden-and-Health-Resource-Utilization-in-Neovascular-Age-related-Macular-Degeneration-(AMD)-Patients-from-Five-Countries.swf

Gisele Soubrane, MD (Creteil, France), Daniel Pauleikhoff, Prof. Dr. med. (Munster, Germany), Alan F. Cruess, MD FRCSC (Halifax, Canada), Andrew Lotery, MD FRCOphth (Southampton, UK),* Jordi Monès, MD (Barcelona, Spain), Xiao Xu, PhD, RN (Gaithersberg, MD),* Gergana Zlateva, PhD (New York, NY),* Thomas F. Goss, MD, PhD (Gaithersberg, MD),* Ronald Buggage, MD (New York, NY),* Manjula Patel, MD (New York, NY)*

PURPOSE:

This study was undertaken to describe the humanistic (quality of life) and economic burden of bilateral subfoveal, neovascular AMD on patient-reported well-being and health resource utilization (HRU) compared to elderly controls without AMD in France, Germany, Spain, the United Kingdom (UK), and Canada.

METHODS:

We surveyed 401 bilateral neovascular AMD patients recruited from retina specialists and 471 elderly non-AMD (control) patients from general practitioners in France, Germany, Spain, UK and Canada in a crosssectional, observational study. Physicians recorded demographic and treatment information. Patients completed a telephone survey of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25), the EuroQol (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), and history of falls, fractures and HRU. The impact of AMD on functioning and HRU was compared between AMD patients and controls using chi-square tests, analysis of variance, and multivariate regression models.

RESULTS:

The mean age of AMD patients was similar across countries (78 years) and 65% were female. AMD patients in all five countries reported substantially worse scores on NEI VFQ Overall scale, EQ-5D, and HADS than the control patients after adjusting for age, gender, and comorbid diseases. AMD patients also reported significantly more health-related problems (i.e., falls and depression treatment) and had substantially higher annual healthrelated costs. The annual cost included direct vision-related medical cost (e.g., treatment of AMD and vision-related equipment), direct non-vision related medical cost (e.g., medications), and direct non-medical related cost (e.g., home healthcare and social services).

CONCLUSION:

Bilateral subfoveal, neovascular AMD is associated with significant humanistic and economic burdens. Bilateral AMD patients reported substantially worse quality of life, poorer visionrelated functioning, and more anxiety and depression symptoms, and up to 8 times higher annual costs compared to subjects without AMD. Early detection and treatment of AMD could substantially reduce these costs.
* Financial interest disclosed