title: Treatment Patterns and Health Care Costs for Age-Related Macular Degeneration in Japan: An Analysis of National Insurance Claims Data.
abstract: To investigate changes in the proportion of patients with age-related macular degeneration (AMD) visiting hospitals and to investigate factors associated with AMD, treatments, and medical expenses, as well as the outlook for AMD in Japan using a large health insurance database.
  
  
  
  Analysis of national insurance claims data.
  
  
  
  People 40 years of age or older who were registered in the Japan Medical Data Center database.
  
  
  
  Patients with AMD were identified from 2005 through 2013 based on International Classification of Diseases, 10th revision, diagnosis codes. Changes in patient proportions, treatment procedures, and medical expenses were investigated during the study period. The data for each year were compared after adjustment based on the 2010 Japanese population annual census. The outlook for patients with AMD was predicted based on the combination of data in 2013 and an official future population prediction report.
  
  
  
  Changes in treatment patterns and health care costs in Japan.
  
  
  
  A total of 3 401 299 participants were included in the analysis, and 3058 AMD patients were identified over the 9-year period. The proportion of patients with AMD increased significantly from 0.084% (95% confidence interval, 0.050%-0.119%) in 2005 to 0.26% (95% confidence interval, 0.24%-0.29%) in 2013 (P = 0.0001, Pearson correlation coefficient test). There were significantly more men than women (odds ratio, 1.25; 95% confidence interval, 1.14-1.37), and the proportion of patients with AMD increased rapidly with age. Photodynamic therapy was replaced by anti-vascular endothelial growth factor (VEGF) therapy as the predominant therapy from 2009 onward. Medical expenses per 10 000 persons increased from $1530 to $137 000 over the 9-year period. The proportion of AMD patients is predicted to increase in the future and will reach a maximum of 223 000 in 2035.
  
  
  
  The proportion of AMD patients visiting hospitals, medical expenses, and the frequency of anti-VEGF therapy increased significantly over the 9-year period. These increasing trends are predicted to continue in Japan.
authors.affiliation: Department of Ophthalmology, Yamanashi University, Chuo Yamanashi, Japan.
authors.forename: Atsuki
authors.initials: A
authors.lastname: Kume
authors.affiliation: Department of Ophthalmology, Yamanashi University, Chuo Yamanashi, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ohshiro
authors.affiliation: Department of Ophthalmology, Yamanashi University, Chuo Yamanashi, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sakurada
authors.affiliation: Department of Ophthalmology, Yamanashi University, Chuo Yamanashi, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kikushima
authors.affiliation: Department of Ophthalmology, Yamanashi University, Chuo Yamanashi, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Yoneyama
authors.affiliation: Department of Ophthalmology, Yamanashi University, Chuo Yamanashi, Japan. Electronic address: kenjik@yamanashi.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kashiwagi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data / Q000639:trends*; D006302:Health Services Research; D006801:Humans; D007564:Japan; D008268:Macular Degeneration / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D010778:Photochemotherapy / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D012042:Registries; D017678:Sex Distribution
chemical_list: D020533:Angiogenesis Inhibitors