title: Costs of newly diagnosed neovascular age-related macular degeneration among medicare beneficiaries, 2004-2008.
abstract: OBJECTIVE
  To examine associations between newly diagnosed neovascular age-related macular degeneration and direct medical costs.
  
  
  METHODS
  This retrospective observational study matched 23,133 Medicare beneficiaries diagnosed with neovascular age-related macular degeneration between 2004 and 2008 with a control group of 92,532 beneficiaries on the basis of age, sex, and race. The index date for each case-control set corresponded to the first diagnosis for the case. Main outcome measures were total costs per patient and age-related macular degeneration-related costs per case 1 year before and after the index date.
  
  
  RESULTS
  Mean cost per case in the year after diagnosis was $12,422, $4,884 higher than the year before diagnosis. Postindex costs were 41% higher for cases than controls after adjustment for preindex costs and comorbid conditions. Age-related macular degeneration-related costs represented 27% of total costs among cases in the postindex period and were 50% higher for patients diagnosed in 2008 than in 2004. This increase was attributable primarily to the introduction of intravitreous injections of vascular endothelial growth factor antagonists. Intravitreous injections averaged $203 for patients diagnosed in 2004 and $2,749 for patients diagnosed in 2008.
  
  
  CONCLUSIONS
  Newly diagnosed neovascular age-related macular degeneration was associated with a substantial increase in total medical costs. Costs increased over time, reflecting growing use of anti-vascular endothelial growth factor therapies.
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina 27715, USA.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Qualls
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Hammill
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.forename: Eleonora M
authors.initials: EM
authors.lastname: Lad
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
authors.forename: Scott W
authors.initials: SW
authors.lastname: Cousins
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000191:economics; D016208:Databases, Factual; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D008297:Male; D016345:Medicare Part B / Q000191:economics*; D012189:Retrospective Studies; D014481:United States; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics*
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A