Burden of illness of bilateral neovascular age-related macular degeneration in Spain^*

ABSTRACT

Background: The burden of illness, including health resource utilization and costs associated with bilateral neovascular age-related macular degeneration (Nv-AMD), was assessed in Spain.

Patients and methods: As part of an international prospective, case-controlled study, 89 Spanish patients with bilateral Nv-AMD were recruited by retina specialists and 96 Spanish control subjects were recruited by general practitioners and ophthalmologists. Physicians recorded clinical data and visual acuity (VA). In a subsequent telephone interview, Nv-AMD patients and controls completed the National Eye Institute Visual Function Questionnaire (NEI VFQ)-25, the EuroQol (EQ-5D), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Annual vision-related and non-vision-related medical costs and non-medical-related costs were calculated from study-specific questions.

Results: The mean age was 76.2 years for Nv-AMD patients and 61.9 years for control subjects. The adjusted mean (95% CI) NEI VFQ-25 summary score was 51.9 (48.5; 55.4) for Nv-AMD patients and 87.7 (85.5; 89.9) for control subjects (p < 0.05). The summary score of Nv-AMD patients decreased significantly with VA declination. Mean direct vision-related medical and non-medical-related costs were significantly greater for Nv-AMD patients than the control subjects, whereas non-vision-related medical costs were similar between groups. The total mean annual resource utilization cost was €5733 for Nv-AMD patients compared to €1070 for control subjects (p < 0.0001).

Conclusions: Although the study design is subject to a number of limitations, patients with Nv-AMD in Spain have worse quality of life outcomes, greater depression, and higher healthcare costs as compared with similarly-aged individuals who are not affected by this disease.

Key words: :

• Age-related macular degeneration
• Burden of illness
• Choroidal neovascularization
• Health resources
• Quality of life
• Visual acuity

Acknowledgments

Declaration of interest: This study was funded by Pfizer Inc. G.Z. is an employee of Pfizer Inc. X.X. is a full time consultant at Covance Inc, the company that held the contract for conducting the study. The authors have no other conflicts of interest to declare.

The authors thank Dr. Gregory Morley, a freelance medical writer, for producing the initial draft in consultation with the authors and for incorporating the reviewers’ comments. The authors also thank Hae Kyung Kim, an employee of Pfizer Spain, for coordinating the submission of this manuscript.

The authors are grateful to the investigators participating in the BOI Study Spanish Group:

Retina Specialists: Amparo Navea (Hospital La Fe, Valencia); Jordi Monés (Instituto de Microcirugía Ocular, Barcelona) and Alfredo Adán (Hospital Clinic i Provincial, Barcelona).

Ophthalmologists and General Practitioners: Inmaculada Pereiró (CS. Trafalgar, Valencia); Nidia R. Varea (CS Alguer. Valencia); Concepción de la Vega (Instituto Oftalmológico Alicante); Salvador G. Delpech (Hospital General Universitario Valencia); Anna Boixadera (Hospital Vall d’Hebron, Barcelona); Laura Pelegrín and Antoni Guitart (Hospital Clinic i Provincial, Barcelona); Enrique Rodríguez de la Rúa (IOBA, Valladolid).