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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Cost of myopic patients with and without myopic choroidal neovascularisation
Journal Information
Vol. 91. Issue 6.
Pages 265-272 (June 2016)
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Vol. 91. Issue 6.
Pages 265-272 (June 2016)
Original article
Cost of myopic patients with and without myopic choroidal neovascularisation
Costes en pacientes miopes magnos con y sin neovascularización coroidea miópica
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296
J.M. Ruiz-Morenoa,
Corresponding author
josemaria.ruiz@uclm.es

Corresponding author.
, M. Rourab, on behalf of the study group Mypathway
a Universidad Castilla La Mancha, Albacete, Spain
b Novartis Farmacéutica, S.A., Barcelona, Spain
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Figures (2)
Tables (4)
Table 1. Demographic and clinical characteristics recorded during the study visit.
Table 2. Health resource use (HRU).
Table 3. Variables included in the multivariate model.
Table 4. Annualised direct and indirect costs per patient.
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Abstract
Objective

To study the costs associated with high myopia (HM) with choroidal neovascularisation (mCNV) or without mCNV.

Methods

Observational, retrospective, cross-sectional, and multicentre study (HM and mCNV) conducted on adult patients. Annualised medical direct cost (MDC) from the perspective of the National Health System, the non-medical direct cost (nMDC) from the patient perspective, and productivity losses were calculated.

Results

A total of 137mCNV and 48 HM patients were included (mean age [SD]: 55.1 [2.8] vs. 54.7 [13.8]; p=0.2), with 80% women in both groups. The observation time (months) ranged from 17.9 (9.6) right eye (RE) and 20.0 (9.7), left eye (LE) in mCNV and 47.1 (21.5) RE/45.5 (20.7) LE in MM. A higher percentage of emergency room visits was observed in mCNV vs. HM patients (41.7 vs. 25%; p=0.06) and retinal specialists (91.2 vs. 77.1%; p=0.01). The MDC was higher in mCNV: € 1985 (95% CI: 1772–2198) vs. € 356 (251–480) HM, p<0.001. The nMDC was also higher in mCNV: € 256 (11–524) vs. € 19 (11–26) HM, p>0.4. The number of affected eyes, the follow-up time, and the mCNV were factors associated with direct costs. The impact on work productivity was higher in mCNV (quite/very concerned): 27.7 vs. 10.4% HM. The mCNV showed a significant association with activity impairment (OR: 3.47, 95% CI: 10.101–1.195).

Conclusions

mCNV involves higher medical costs than HM. In addition, mCNV patients have a greater need of care and assistive devices, and greater impact of the disease in their work productivity.

Keywords:
Choroidal neovascularisation
High myopia
Direct costs
Indirect costs
Work productivity
Resumen
Objetivo

Estudiar los costes asociados a la enfermedad en pacientes miopes magnos (MM) con neovascularización coroidea miópica (NVCm) y sin NVCm.

Métodos

Estudio observacional, retrospectivo, transversal, multicéntrico de pacientes MM adultos con y sin NVCm. Se calcularon anualizados el coste directo médico (CDM) desde la perspectiva del Sistema Nacional de Salud, el coste directo no médico (CDnM) desde la perspectiva del paciente y los costes derivados de la pérdida de productividad laboral.

Resultados

Se incluyeron 137 NVCm y a 48 MM pacientes (edad media [DE]: 55,1 [2,8] vs. 54,7 [13,8]; p=0,2). El 80% fueron mujeres en ambos grupos. El tiempo de observación (meses) osciló entre 17,9 (9,6) en el ojo derecho (OD) y 20,0 (9,7) en el ojo izquierdo (OI) en NVCm y 47,1 (21,5) OD y 45,5 (20,7) OI en MM. Se observó un mayor porcentaje de visitas a urgencias en pacientes NVCm vs. MM (41,7 vs. 25%; p=0,06) y a especialistas de retina (91,2 vs. 77,1%; p=0,01). El CDM fue mayor en NVCm: 1.985€ (IC 95%: 1.772-2.198) vs. 356€ (251-480) MM; p<0,001. El CDnM también fue más alto en NVCm: 256€ (11-524) vs. 19€ (11-26) MM; p>0,4. El número de ojos afectos, tiempo de seguimiento y NVCm se asociaron con los costes directos. El impacto en la actividad laboral fue mayor en NVCm (bastante/muy afectados): 27,7 vs. 10,4% en MM. La NVCm mostró una asociación significativa con la afectación laboral (OR: 3,47; IC 95%: 10,101-1,195).

Conclusiones

La NVCm implica un coste médico más elevado que la MM. Los pacientes con NVCm presentan una mayor necesidad de cuidados y de dispositivos de ayuda, así como un mayor impacto de la enfermedad en su vida profesional.

Palabras clave:
Neovascularización miópica
Miopía magna
Costes directos
Costes indirectos
Productividad laboral

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