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Burden of illness, visual impairment and health resource utilisation of patients with neovascular age-related macular degeneration: results from the UK cohort of a five-country cross-sectional study

¹ University of Southampton, Southampton, UK
² Covance Market Access Services, Gaithersburg, Maryland, USA
³ Pfizer Inc. New York, USA
⁴ Pfizer Ltd, UK

Correspondence to:
Professor Andrew Lotery, University of Southampton, Southampton Eye Unit, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; a.j.lotery{at}soton.ac.uk

ABSTRACT
Background/aims: Quantitative data regarding the impact of neovascular age-related macular degeneration (NV-AMD) on individuals and society is a prerequisite for rational decision-making processes when evaluating alternative treatments for the disease.

Methods: 75 bilateral NV-AMD (patients) and 91 elderly non-AMD (controls) subjects forming the UK cohort of an international cross-sectional, observational study were independently analysed. Subjects completed a telephone survey including the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), the EuroQol (EQ-5D), the Hospital Anxiety and Depression Scale (HADS), history of falls and health resource utilisation.

Results: Patients with NV-AMD reported substantially worse vision-related functioning and overall well-being, including higher depression scores, than controls after adjusting for age, gender and co-morbidities (adjusted mean scores: NEI-VFQ-25 overall 52.7 vs 90.7, p<0.0001; EQ-5D 0.67 vs 0.77, p = 0.0273; HADS depression 6.8 vs 4.0, p = 0.0026). Significantly more patients reported a need for assistance with daily activities compared with controls (25.3% vs 6.6%, p = 0.003). Total annual healthcare utilisation costs were more than sevenfold higher for patients with AMD compared with controls (£3,823.89 vs £517.05, respectively; p<0.0001)

Conclusions: Patients with NV-AMD show a significant decline in quality of life and increased need for daily living assistance compared to a control population without AMD. With the availability of effective new therapies there is a need for improved early access to treatment.

Abbreviations: ADL, activities of daily living; AMD, age-related macular degeneration; EQ-5D, EuroQol questionnaire; HADS, Hospital Anxiety and Depression Scale; HRU, health resource utilisation; NEI-VFQ-25, National Eye Institute Visual Function Questionnaire; NV-AMD, neovascular age-related macular degeneration; QOL, quality of life; VA, visual acuity