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美国与新生血管性年龄相关性黄斑变性相关的社会成本。

SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.

作者信息

Brown Melissa M, Brown Gary C, Lieske Heidi B, Tran Irwin, Turpcu Adam, Colman Shoshana

机构信息

*Center for Value-Based Medicine, Flourtown, Pennsylvania; †The Eye Research Institute, Philadelphia, Pennsylvania; ‡The Research Department, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania; §The Retina Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania; ¶Healthcare Economics Unit, Genentech Roche, United Kingdom; and **Healthcare Economics Unit, Genentech, Inc, South San Francisco, California.

出版信息

Retina. 2016 Feb;36(2):285-98. doi: 10.1097/IAE.0000000000000717.

Abstract

PURPOSE

The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration.

METHODS

Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration.

RESULTS

The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P < 0.001). Study Subcohort 1 costs averaged $20,339, while Subcohort 4 costs averaged $82,984. Direct ophthalmic medical costs comprised 17.9% of Study Cohort societal ophthalmic costs, versus 74.1% of Control Cohort societal ophthalmic costs (P < 0.001) and 10.4% of 20/800 to no light perception subcohort costs. Direct nonmedical costs, primarily caregiver, comprised 67.1% of Study Cohort societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P < 0.001) and 74.1% of 20/800 to no light perception subcohort costs.

CONCLUSION

Total societal ophthalmic costs associated with neovascular age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.

摘要

目的

本研究旨在通过一项基于患病率的横断面医疗保健经济调查,确定与新生血管性年龄相关性黄斑变性相关的年度、增量、社会眼科成本。

方法

对连续纳入的200例新生血管性年龄相关性黄斑变性患者进行研究。一个对照组包括视力良好(20/20 - 20/25)的患者,而研究组的视力水平包括亚组1:20/30至20/50,亚组2:20/60至20/100,亚组3:20/200至20/400,以及亚组4:20/800至无光感。由访员实施的标准化书面调查评估了:1)直接眼科医疗费用,2)直接非眼科医疗费用,3)直接非医疗费用,以及4)仅因新生血管性年龄相关性黄斑变性产生的间接医疗费用。

结果

对照组的平均年度社会成本为6,116美元,研究组的平均成本为39,910美元(P < 0.001)。研究亚组1的成本平均为20,339美元,而亚组4的成本平均为82,984美元。直接眼科医疗费用占研究组社会眼科成本的17.9%,而对照组社会眼科成本的这一比例为74.1%(P < 0.001),在20/800至无光感亚组成本中占10.4%。直接非医疗费用主要是护理费用,占研究组社会眼科成本的67.1%,而对照组成本的这一比例为21.3%(1,302美元/6,116美元)(P < 0.001),在20/800至无光感亚组成本中占74.1%。

结论

随着较好眼视力下降,与新生血管性年龄相关性黄斑变性相关的社会眼科总成本显著增加。

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