The Economics of Age-Related Macular Degeneration

  • Gary C. Brown
  • Melissa M. Brown
  • Heidi B. Lieske
  • Philip A. Lieske
  • Kathryn Brown
Chapter
First Online:

Abstract

The Patient Protection and Affordable Care Act of 2010 funded the Patient-Centered Outcomes Research Institute to promote the use of comparative effectiveness analysis and cost-­effectiveness analysis in the Unites States. There are four healthcare economic analysis variants: (1) cost-minimization analysis, (2) cost-benefit analysis, (3) cost-effectiveness analysis, and (4) cost-utility analysis. Cost-utility analysis, which uses the outcome $/QALY (dollars expended per QALY gained) is the most sophisticated. The comparative effectiveness, or human value gain conferred by an intervention can be objectively measured using the QALY (quality-adjusted life year). Most commonly, only the direct ophthalmic medical costs of therapy for neovascular age-related macular degeneration (AMD) are addressed in the literature. Societal costs are more desirable. Intravitreal ranibizumab therapy versus no therapy for subfoveal neovascular AMD confers a 15.9–28.2% value gain (improvement in the quality of life), intravitreal bevacizumab with intraocular brachytherapy a 22.4% value gain, photodynamic therapy an 8.1% value gain, intravitreal pegaptanib a 5.9% value gain, and laser therapy a 4.4% value gain. Extrafoveal laser photocoagulation confers an 8.1% value gain over no therapy.

Keywords

Gross Domestic Product Caregiver Cost Direct Nonmedical Cost Ranibizumab Therapy Comparative Effectiveness Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Financial Disclosure

Supported in part by the Center for Value-Based Medicine®, Flourtown, PA, the sponsor played no role in performance of the study, writing of the manuscript, or requiring direction of the study.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Gary C. Brown
    • 1
    • 2
  • Melissa M. Brown
    • 3
    • 4
  • Heidi B. Lieske
    • 4
  • Philip A. Lieske
    • 4
  • Kathryn Brown
    • 4
  1. 1.Department of OphthalmologyJefferson Medical CollegeWyndmooreUSA
  2. 2.Center for Value-Based MedicineFlourtownUSA
  3. 3.Department of OphthalmologyJefferson Medical CollegeWyndmooreUSA
  4. 4.Center for Value-Based MedicineFlourtownUSA

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