OSLI Retina

April 2020 Supplement

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S6 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ■ C L I N I C A L S C I E N C E ■ Social Cost of Blindness Due to AMD and Diabetic Retinopathy in the United States in 2020 Andrew A. Moshfeghi, MD, MBA; Tereza Lanitis, MSc; Georg Kropat, PhD; Andreas Kuznik, PhD; Andrea Gibson, PhD; Haidong Feng, MPH; Jonathan Prenner, MD BACKGROUND AND OBJECTIVE: To estimate the so- cial cost of blindness due to wet age-related macu- lar degeneration (wAMD), diabetic macular edema (DME), and proliferative diabetic retinopathy (PDR) in the United States in 2020. PATIENTS AND METHODS: Excess costs that occur because of blindness were estimated as the differ- ence in costs in blind versus non-blind individuals. Per-patient costs were aggregated using the number of cases of blindness due to wAMD, DME, and PDR projected in 2020. RESULTS: Associated annual excess direct costs, in- direct costs, and quality-adjusted life year loss per blind individual were $4,944, $54,614, and 0.214, respectively. Combining estimates with 246,423 projected cases of blindness due to wAMD, DME, and PDR translated to total societal costs of $20 bil- lion in 2020, estimated to triple by 2050. CONCLUSION: Excess social costs associated with blindness in individuals with wAMD, DME, and PDR are substantial, with more than half of the bur- den attributed to indirect costs. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S6-S14.] INTRODUCTION Individuals with blindness have lower quality of life compared to individuals without visual impair- ment 1 and require significant medical and social resources. 2-4 Estimated annual costs for blind indi- viduals range from $14,882 to $24,180, which is al- most double the costs for non-blind individuals. 5 Additionally, blindness is associated with high indi- rect and intangible costs, including caregiving costs, productivity losses, premature mortality, and excess financial burden. On a societal level, consequences can be substantial. The annual cost of adult vision problems in the United States (U.S.) in 2007 was ap- proximately $51.4 billion. 6 One in five cases of blindness in the U.S. are at- tributable to retinal diseases characterized by angio- genic processes in retinal blood vessels. 7 Key among these are age-related macular degeneration (AMD) and diabetic retinopathy (DR), with complications such as diabetic macular edema (DME) and prolifera- tive DR (PDR). Though these diseases represent some of the primary causes of blindness in the U.S., they are largely preventable. Laser photocoagulation and intravitreal anti-vascular endothelial growth factor (VEGF) therapies that inhibit this protein have been shown to improve or maintain vision in individuals with wet AMD (wAMD), DME, retinal vein occlusion (RVO), and PDR. 8-10 From Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California (AAM); Evidera, London, United Kingdom (TL, GK); Regeneron Pharmaceuticals, Tarrytown, New York (AK, AG); Evidera, Waltham, Massachussetts (HF); and the Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey (JP). Originally submitted August 1, 2019. Revision received August 1, 2019. Accepted for publication August 27, 2019. Supported by by Regeneron Pharmaceuticals and, in part, by an unrestricted grant to the Department of Ophthalmology at the University of Southern California Keck School of Medicine from Research to Prevent Blindness (New York, NY). Dr. Moshfeghi has served as a consultant to Regeneron, Genentech, Allergan, Visunex, Valeant, Spark, EyePoint, Allegro, and Novartis and has equity interest in Pr3vent, OptiSTENT, and Visunex. Drs. Lanitis, Kropat, and Feng are employees of Evidera, who were paid consultants to Regeneron in relation to this study. Drs. Kuznik and Gibson are employees of, and own stock and stock options in, Regeneron, the manufacturer of Eylea. Dr. Prenner was a consultant to Regeneron in relation to this study and has served as a consultant to Alcon. Medical writing and editorial support were provided by Brenda MacIntyre, RPh, and Melanie Jardim, PhD, (Evidera, Morrisville, NC) and funded by Regen- eron Pharmaceuticals. Address correspondence to Jonathan Prenner, MD, Department of Ophthalmology, Rutgers Robert Wood Johnson Medical School, 10 Plum Street, New Brunswick, NJ 08901; email: jonathanprenner@gmail.com. doi: 10.3928/23258160-20200401-01 TOP ABSTRACTS From RWC

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