Treating retinal vein occlusions in France, Germany, and Italy: an analysis of treatment patterns, resource consumption, and costs.
OBJECTIVE
To describe treatment patterns among patients with central or branch retinal vein occlusion (CRVO or BRVO) in France, Germany, and Italy, and to estimate retinal vein occlusion (RVO)-related direct medical costs.


METHODS
We used a retrospective chart review to determine 18-month RVO-related resource utilization and calculate 12-month health care costs. Country-specific unit costs (€) were assigned to each resource from the perspective of the health care payer. Costs for France and Germany were based on 2005, and for Italy on 2007 values.


RESULTS
Data from a total of 109 BRVO and 119 patients with CRVO were used in the analysis. Laser therapy was the most commonly used intervention in Germany, for both CRVO and patients with BRVO (95%-98% of treatments), while patients in France with either condition had triamcinolone injections most often (63%-67% of treatments). Injections were also administered frequently in Italy and were the most common treatment for CRVO (50%), whereas patients with BRVO used laser therapy most often (41%). Inpatient treatment was most common in Germany (42% of CRVO and 34% of patients with BRVO), and did not occur at all in Italy except for day admissions. Total costs were higher for patients with CRVO in all countries. Most costs in Italy and France were attributable to outpatient treatment. In Germany, hospitalization made up the largest proportion of costs (80%), although more patients used outpatient services.


CONCLUSIONS
Approaches to treating BRVO and CRVO vary across European countries. Development of agreed-upon guidelines would support consistency in patient care and reimbursement policy.
Augenklinik, Klinikum Karlsruhe, Karlsruhe, Germany. albertjaugustin@googlemail.com
Albert J
AJ
Augustin
Jose-Alain
JA
Sahel
Luciano
L
Cerulli
Brigitte
B
Texier-Richard
Patricia M
PM
Buchholz
Gisela
G
Kobelt
D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D058449:Intravitreal Injections; D007558:Italy / Q000453:epidemiology; D017075:Laser Coagulation; D008269:Macular Edema / Q000191:economics / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012170:Retinal Vein Occlusion / Q000191:economics* / Q000628:therapy*; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide