title: The burden of age-related macular degeneration: results of a cohort study in two French referral centres.
abstract: OBJECTIVE
  To describe the economic impact of age-related macular degeneration (AMD) and to assess its medical and non-medical costs.
  
  
  METHODS
  An observational study was carried out in 105 patients in two French centres in a sample of 105 French patients. All consecutive patients, consulting during a 3-week period, were included provided they were 60 years of age or older and they presented an exudative form of AMD with a distant visual acuity in the best eye < or = 20/40. Data collected included clinical items, treatment modalities, medical follow-up, transport costs, impact of AMD on living conditions and welfare payments related to visual impairment. Costs were presented in 2000 values.
  
  
  CONCLUSIONS
  General payer perspective (Social Security, private health insurance and patient).
  
  
  RESULTS
  Mean age was 79.3 years and ranged from 62.8-95 years. Average length of disease evolution was 3.5 years. During a 3-month period, patients had a mean of 2.6 visits to the ophthalmologist. Thirty percent of the patients used vascular medications and 72.4% had been previously treated by laser photocoagulation. Only 10% had benefited from visual rehabilitation. Annual AMD cost per patient was 3660.29 euros (EUR) [95% CI: 2881.92-4438.62]. Half of these annual costs were medical costs. Other major cost components were home help costs EUR904.91 [95% CI: 478.88-1330.94] and transport costs for care EUR542.73 [95% CI: 146.31-939.14]. Non-medical costs were significantly higher for patients with more severe disease.
  
  
  CONCLUSIONS
  The economic argument that costs are higher in patients with the lowest visual acuity emphasises the necessity of early detection and treatment of patients with AMD.
authors.affiliation: CLP-Santé, Paris, France.
authors.forename: Julia
authors.initials: J
authors.lastname: Bonastre
authors.forename: Claude
authors.initials: C
authors.lastname: Le Pen
authors.forename: Gisèle
authors.initials: G
authors.lastname: Soubrane
authors.forename: Gabriel
authors.initials: G
authors.lastname: Quentel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001296:Audiovisual Aids / Q000706:statistics & numerical data; D015331:Cohort Studies; D017281:Cost of Illness; D005602:France; D006801:Humans; D008268:Macular Degeneration / Q000191:economics* / Q000628:therapy; D008875:Middle Aged; D014792:Visual Acuity