Healthcare Resource Utilization and the Economic Burden of Neovascular Age-Related Macular Degeneration (nAMD): A Systematic Literature Review
Author(s)
Joelle A. Hallak, MS, PhD1, Inderpreet Khurana, MPharm2, Paul Oyefesobi, PharmD, RPh3, Vasudha Mukherjee, MBA1, Tanya Madan, BPharm2, Francesca Cook, MPH3, Joice T. Huang, MBA1;
1Allergan, an AbbVie Company, Irvine, CA, USA, 2Lumanity, Gurugram, India, 3REGENXBIO Inc., Rockville, MD, USA
1Allergan, an AbbVie Company, Irvine, CA, USA, 2Lumanity, Gurugram, India, 3REGENXBIO Inc., Rockville, MD, USA
OBJECTIVES: nAMD, an advanced stage of age-related macular degeneration (AMD), is a leading cause of blindness in individuals aged ≥65 years. Recommended treatment comprises monthly intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) therapies. We performed a systematic literature review to assess costs associated with nAMD and its treatment.
METHODS: Biomedical publication and health technology assessment (HTA) databases, including MEDLINE, Embase, NHS EED, HTAD, EconLit, and Ichushi Web were searched from database inception to July 2023, and supplemented by manual reviews of conference proceedings and HTA body websites. Two independent reviewers assessed results against inclusion criteria to identify publications reporting costs, cost-effectiveness, utility, and/or resource use for nAMD and nAMD therapies among patients with nAMD or wet AMD treated with an intervention of interest alone.
RESULTS: In total, 211 records were included (157 from electronic databases and 54 from supplementary searches) that reported on 192 unique studies. nAMD was associated with a substantial cost and resource use burden from societal and healthcare system perspectives. In the USA, annual mean societal ophthalmic costs were significantly higher in the cohort with mild to very severe vision loss vs the control cohort (no/negligible vision loss; $39,910 vs $6,116 per capita; P<0.001). Anti-VEGF treatment (measured using the payment fields on extracted claims and including gross-covered payments for the anti-VEGF agent alone) was associated with substantial annual treatment costs (at 12 months: ranibizumab, $11,351; aflibercept, $10,702; at 24 months: ranibizumab, $16,286; aflibercept, $16,666), with the burden potentially underestimated as patients may receive fewer injections than recommended.
CONCLUSIONS: nAMD and anti-VEGF therapies are associated with a considerable cost burden to society and healthcare systems, with costs increasing with worsening vision. Our results suggest that nAMD management can benefit from newer treatments that offer more durable vision maintenance, ultimately reducing injection burden and cost for re-treatment.
METHODS: Biomedical publication and health technology assessment (HTA) databases, including MEDLINE, Embase, NHS EED, HTAD, EconLit, and Ichushi Web were searched from database inception to July 2023, and supplemented by manual reviews of conference proceedings and HTA body websites. Two independent reviewers assessed results against inclusion criteria to identify publications reporting costs, cost-effectiveness, utility, and/or resource use for nAMD and nAMD therapies among patients with nAMD or wet AMD treated with an intervention of interest alone.
RESULTS: In total, 211 records were included (157 from electronic databases and 54 from supplementary searches) that reported on 192 unique studies. nAMD was associated with a substantial cost and resource use burden from societal and healthcare system perspectives. In the USA, annual mean societal ophthalmic costs were significantly higher in the cohort with mild to very severe vision loss vs the control cohort (no/negligible vision loss; $39,910 vs $6,116 per capita; P<0.001). Anti-VEGF treatment (measured using the payment fields on extracted claims and including gross-covered payments for the anti-VEGF agent alone) was associated with substantial annual treatment costs (at 12 months: ranibizumab, $11,351; aflibercept, $10,702; at 24 months: ranibizumab, $16,286; aflibercept, $16,666), with the burden potentially underestimated as patients may receive fewer injections than recommended.
CONCLUSIONS: nAMD and anti-VEGF therapies are associated with a considerable cost burden to society and healthcare systems, with costs increasing with worsening vision. Our results suggest that nAMD management can benefit from newer treatments that offer more durable vision maintenance, ultimately reducing injection burden and cost for re-treatment.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE152
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)