title: Costs and Quality of Life in Diabetic Macular Edema: Canadian Burden of Diabetic Macular Edema Observational Study (C-REALITY).
abstract: Purpose. To characterize the economic and quality of life burden of diabetic macular edema (DME) in Canadian patients. Patients and Methods. 145 patients with DME were followed for 6 months with monthly telephone interviews and medical chart reviews at months 0, 3, and 6. Visual acuity in the worst-seeing eye was assessed at months 0 and 6. DME-related healthcare costs were determined over 6 months, and vision-related (National Eye Institute Visual Functioning Questionnaire) and generic (EQ-5D) quality of life was assessed at months 0, 3, and 6. Results. Mean age of patients was 63.7 years: 52% were male and 72% had bilateral DME. At baseline, visual acuity was categorized as normal/mild loss for 63.4% of patients, moderate loss for 10.4%, and severe loss/nearly blind for 26.2%. Mean 6-month DME-related costs/patient were as follows: all patients (n = 135), $2,092; normal/mild loss (n = 88), $1,776; moderate loss (n = 13), $1,845; and severe loss/nearly blind (n = 34), $3,007. Composite scores for vision-related quality of life declined with increasing visual acuity loss; generic quality of life scores were highest for moderate loss and lowest for severe loss/nearly blind. Conclusions. DME-related costs in the Canadian healthcare system are substantial. Costs increased and vision-related quality of life declined with increasing visual acuity severity.
authors.affiliation: Ivey Eye Institute, St. Joseph's Health Centre, 268 Grosvenor Street, London, ON, Canada N6A 4V2.
authors.forename: John R
authors.initials: JR
authors.lastname: Gonder
authors.affiliation: OptumInsight, 5500 North Service Road, Suite 501, Burlington, ON, Canada L7L 6W6.
authors.forename: Valery M
authors.initials: VM
authors.lastname: Walker
authors.affiliation: Novartis Pharmaceuticals Canada, 385 Bouchard Boulevard, Dorval, QC, Canada H9S 1A9.
authors.forename: Martin
authors.initials: M
authors.lastname: Barbeau
authors.affiliation: Novartis Pharmaceuticals Canada, 385 Bouchard Boulevard, Dorval, QC, Canada H9S 1A9.
authors.forename: Nancy
authors.initials: N
authors.lastname: Zaour
authors.affiliation: OptumInsight, 5500 North Service Road, Suite 501, Burlington, ON, Canada L7L 6W6.
authors.forename: Bryan H
authors.initials: BH
authors.lastname: Zachau
authors.affiliation: OptumInsight, 5500 North Service Road, Suite 501, Burlington, ON, Canada L7L 6W6.
authors.forename: James R
authors.initials: JR
authors.lastname: Hartje
authors.affiliation: Novartis Pharmaceuticals Canada, 385 Bouchard Boulevard, Dorval, QC, Canada H9S 1A9.
authors.forename: Ruihong
authors.initials: R
authors.lastname: Li