Burden of illness of diabetic macular edema: literature review

Abstract

Objective:

To provide an overview of the literature on the burden of diabetic macular edema (DME) in the United States and selected European countries.

Research design and methods:

Computerized searches of English-language literature were conducted in PubMed/MEDLINE (1980–2009). The searches were supplemented with electronic and manual searches of relevant society/association proceedings and bibliographies of electronically identified sources. Abstracts were reviewed for relevance to any of the following topics: epidemiology, including prevalence and incidence; health outcomes; resource use and treatment patterns; and economic and humanistic burden associated with DME. Relevant full text articles were retrieved and major findings were synthesized and compared within and across countries.

Results:

A total of 400 citations were included in the initial review. After abstract screening, 47 articles were deemed pertinent and summarized in this review. The prevalence of DME among diabetic patients ranged from 0.85% to 12.3% across the countries studied. The prevalence and incidence of DME vary depending on type of diabetes (1 vs. 2), insulin- vs. non-insulin-dependence, and duration of disease (years since diagnosis). Although literature findings are limited and indicate a need for further investigation, a synthesis of the available results indicates that DME has a negative impact on patients’ health-related quality of life. In addition, patients with DME consume significantly more healthcare resources and incur higher costs compared to diabetic patients without retinal complications.

Conclusions:

There remains a need for consistent data capture and assessment within and between countries included in this analysis. Despite the limited evidence, DME appears to be a costly disease that has a negative impact on patients’ quality of life.

Key words::

• Burden of illness
• Cost
• Diabetic macular edema
• Incidence
• Prevalence
• Quality of life

Transparency

Declaration of funding

Funding of this study was provided by Novartis Pharma AG. The sponsor participated in the study design and manuscript review and approval, but was not involved in the search, review, synthesis and interpretation of the results.

Declaration of financial/other relationships

E.C., M.L. and M.L. have disclosed that they are employees of Quorum Consulting Inc. M.L. D.L., E.C., and K.V. have also disclosed that they are consultants for, and have received funding for this research from, Novartis. M.G. has disclosed that she is an employee of Novartis Pharma AG. K.V. has disclosed that she is an employee of Precision Health Economics. D.L. has disclosed that he is an employee of University of Southern California and the RAND Corporation. J.F. has disclosed that she is an employee of Novartis Farmaceutica S.A. Barcelona, Spain.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgment

The authors have disclosed that they had no outside editorial assistance in preparing this manuscript.