COSTS OF NEWLY DIAGNOSED NEOVASCULAR AGE-RELATED MACULAR DEGENERATION AMONG MEDICARE BENEFICIARIES, 2004–2008

• DOI: 10.1097/iae.0b013e31826f065e
• Publication Date: 2013-01-05T09:56:51Z
• Authors: Laura G. Qualls; Bradley G. Hammill; Fang Wang; Eleonora M. Lad; Kevin A. Schulman; Scott W. Cousins; Lesley H. Curtis
• Keywords: Aged, 80 and over; Male; Vascular Endothelial Growth Factor A; Databases, Factual; Angiogenesis Inhibitors; United States; Direct Service Costs; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Wet Macular Degeneration; Humans; Female; Medicare Part B; Health Services Research; Health Expenditures; Aged; Retrospective Studies

To examine associations between newly diagnosed neovascular age-related macular degeneration and direct medical costs.This retrospective observational study matched 23,133 Medicare beneficiaries diagnosed with neovascular age-related macular degeneration between 2004 and 2008 with a control group of 92,532 beneficiaries on the basis of age, sex, and race. The index date for each case-control set corresponded to the first diagnosis for the case. Main outcome measures were total costs per patient and age-related macular degeneration-related costs per case 1 year before and after the index date.Mean cost per case in the year after diagnosis was $12,422, $4,884 higher than the year before diagnosis. Postindex costs were 41% higher for cases than controls after adjustment for preindex costs and comorbid conditions. Age-related macular degeneration-related costs represented 27% of total costs among cases in the postindex period and were 50% higher for patients diagnosed in 2008 than in 2004. This increase was attributable primarily to the introduction of intravitreous injections of vascular endothelial growth factor antagonists. Intravitreous injections averaged $203 for patients diagnosed in 2004 and $2,749 for patients diagnosed in 2008.Newly diagnosed neovascular age-related macular degeneration was associated with a substantial increase in total medical costs. Costs increased over time, reflecting growing use of anti-vascular endothelial growth factor therapies.