Relationship between treatment and cost with visual acuity improvement in age-related macular degeneration

Abstract

Background. We examined the relationship between visual acuity (VA) changes 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. Follow-up and treatment were done in our 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), increased 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 antiVEGF 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.