title: Health resource utilization and the economic burden of patients with wet age-related macular degeneration in Thailand.
abstract: OBJECTIVE
  To determine healthcare resource utilization and the economic burden associated with wet age-related macular degeneration (AMD) in Thailand.
  
  
  METHODS
  This study included patients diagnosed with wet AMD that were 60 years old or older, and had best corrected visual acuity (BCVA) measured at least two times during the follow-up period. We excluded patients having other eye diseases. Two separate sub-studies were conducted. The first sub-study was a retrospective cohort study; electronic medical charts were reviewed to estimate the direct medical costs. The second sub-study was a cross-sectional survey estimating the direct non-medical costs based on face-to-face interviews using a structured questionnaire. For the first sub-study, direct medical costs, including the cost of drugs, laboratory, procedures, and other treatments were obtained. For the second sub-study, direct non-medical costs, e.g. transportation, food, accessories, home renovation, and caregiver costs, were obtained from face-to-face interviews with patients and/or caregivers.
  
  
  RESULTS
  For the first sub-study, sixty-four medical records were reviewed. The annual average number of medical visits was 11.1±6.0. The average direct medical costs were $3 604±4 530 per year. No statistically-significant differences of the average direct medical costs among the BCVA groups were detected (P=0.98). Drug costs accounted for 77% of total direct medical costs. For direct non-medical costs, 67 patients were included. Forty-eight patients (71.6%) required the accompaniment of a person during the out-patient visit. Seventeen patients (25.4%) required a caregiver at home. The average direct non-medical cost was $2 927±6 560 per year. There were no statistically-significant differences in the average costs among the BCVA groups (P=0.74). Care-giver cost accounted for 87% of direct non-medical costs.
  
  
  CONCLUSIONS
  Our study indicates that wet AMD is associated with a substantial economic burden, especially concerning drug and care-giver costs.
authors.affiliation: Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand.
authors.forename: Piyameth
authors.initials: P
authors.lastname: Dilokthornsakul
authors.affiliation: Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand ; Discipline of Pharmacy, Monash University Malaysia, Selangor 46150, Malaysia ; School of Population Health, University of Queensland, Brisbane QLD 4072, Australia ; School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53706, USA.
authors.forename: Nathorn
authors.initials: N
authors.lastname: Chaiyakunapruk
authors.affiliation: Department of Ophthalmology, Rajavithi Hospital, Bangkok 10400, Thailand.
authors.forename: Paisan
authors.initials: P
authors.lastname: Ruamviboonsuk
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
authors.forename: Mansing
authors.initials: M
authors.lastname: Ratanasukon
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chiangmai University, Chiangmai 50200, Thailand.
authors.forename: Somsanguan
authors.initials: S
authors.lastname: Ausayakhun
authors.affiliation: Department of Ophthalmology, Rajavithi Hospital, Bangkok 10400, Thailand.
authors.forename: Akrapope
authors.initials: A
authors.lastname: Tungsomeroengwong
authors.affiliation: Department of Ophthalmology, Rajavithi Hospital, Bangkok 10400, Thailand.
authors.forename: Nattapol
authors.initials: N
authors.lastname: Pokawattana
authors.affiliation: Novartis (Thailand) Ltd., Bangkok 10110, Thailand.
authors.forename: Chalakorn
authors.initials: C
authors.lastname: Chanatittarat
keywords: Thailand; age-related macular degeneration; costs; health resource utilization