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Anales del Sistema Sanitario de Navarra
Print version ISSN 1137-6627
Abstract
CASANOVAS-MARSAL, Josep-Oriol et al. Relationship between treatment and cost with visual acuity improvement in age-related macular degeneration. Anales Sis San Navarra [online]. 2023, vol.46, n.3, e1052. Epub Mar 18, 2024. ISSN 1137-6627. https://dx.doi.org/10.23938/assn.1052.
Background:
We examined the relationship between visual acuity changes (VA) and the cost of care and treatment with anti-vascular endothelial growth factors (antiVEGF) in patients diagnosed with age-related exudative macular degeneration(exudative AMD).
Methods:
Observational, longitudinal, retrospective study of patients ≥50 years of age diagnosed with exudative AMD, with a logMAR VA between 0.6 and 0.06. and 0.06. Follow-up and treatment were done in our tertiary hospital between January 1, 2014 and December 31, 2018.
Results:
The study included 778 patients; 62.2% female and mean age 79.83±7.94 years; 957 eyes had exudative AMD. Mean of final VA (0.65±0.45) increasing 3.2% compared to initial values. Ranibizumab was administered to 60.3% of the eyes, aflibercept to 10.2% and ranibizumab + aflibercept (mixed group) to 29.5%. Significant increase in VA was seen in the group with the mixed treatment, with no inter-group differences. Although follow-up/treatment was longer for the mixed group, they received fewer anti-VEGF injections and optical coherence tomography (OCT). The total expenditure per year and treated eye was € 1,972.7±824.5; costs were higher for visit, OCT, and treatment in the aflibercept group, and lower for fluorescein angiography, antiVEGF treatment, and total costs in the mixed group. Decimal VA gain had a cost of € 872±1,077.7 with no significant inter-group differences.
Conclusion:
AntiVEGF treatments (ranibizumab, aflibercept, or both) maintained VA in patients with exudative AMD. Overall, care and treatment costs were lower in the group that received both drugs.
Keywords : Wet macular degeneration; Health care costs; Vascular endothelial growth factors; Cost-benefit analysis.