title: SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.
abstract: OBJECTIVE
  The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration.
  
  
  METHODS
  Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration.
  
  
  RESULTS
  The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P < 0.001). Study Subcohort 1 costs averaged $20,339, while Subcohort 4 costs averaged $82,984. Direct ophthalmic medical costs comprised 17.9% of Study Cohort societal ophthalmic costs, versus 74.1% of Control Cohort societal ophthalmic costs (P < 0.001) and 10.4% of 20/800 to no light perception subcohort costs. Direct nonmedical costs, primarily caregiver, comprised 67.1% of Study Cohort societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P < 0.001) and 74.1% of 20/800 to no light perception subcohort costs.
  
  
  CONCLUSIONS
  Total societal ophthalmic costs associated with neovascular age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.
authors.affiliation: *Center for Value-Based Medicine, Flourtown, Pennsylvania; †The Eye Research Institute, Philadelphia, Pennsylvania; ‡The Research Department, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania; §The Retina Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania; ¶Healthcare Economics Unit, Genentech Roche, United Kingdom; and **Healthcare Economics Unit, Genentech, Inc, South San Francisco, California.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Brown
authors.forename: Gary C
authors.initials: GC
authors.lastname: Brown
authors.forename: Heidi B
authors.initials: HB
authors.lastname: Lieske
authors.forename: Irwin
authors.initials: I
authors.lastname: Tran
authors.forename: Adam
authors.initials: A
authors.lastname: Turpcu
authors.forename: Shoshana
authors.initials: S
authors.lastname: Colman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D004470:Economics, Medical; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000191:economics*; D015995:Prevalence; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000191:economics* / Q000628:therapy