The Association of Retinal Disease with Vision Impairment and Functional Status in Medicare Patients.

Autor:	Garmo V; Genentech, Inc., South San Francisco, California, USA., Zhao X; IQVIA, Durham, North Carolina, USA., Ng CD; Genentech, Inc., South San Francisco, California, USA., Near A; IQVIA, Durham, North Carolina, USA., Banerji T; IQVIA, Durham, North Carolina, USA., Wada K; IQVIA, Durham, North Carolina, USA., Oderda G; University of Utah, Salt Lake City, Utah, USA., Brixner D; University of Utah, Salt Lake City, Utah, USA., Biskupiak J; University of Utah, Salt Lake City, Utah, USA., Ali FS; New York Medical College, Valhalla, New York, USA., Khanani AM; Sierra Eye Associates, Reno, Nevada.; School of Medicine University of Nevada, Reno., Menezes A; Genentech, Inc., South San Francisco, California, USA., Abbass IM; Genentech, Inc., South San Francisco, California, USA.
Jazyk:	angličtina
Zdroj:	Journal of health economics and outcomes research [J Health Econ Outcomes Res] 2024 Mar 29; Vol. 11 (1), pp. 94-102. Date of Electronic Publication: 2024 Mar 29 (Print Publication: 2024).
DOI:	10.36469/001c.93022
Abstrakt:	Background: The association of neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) with functional status in the general Medicare population are not well established. Objectives: This study examined patient-reported survey data linked with Medicare claims to describe the burden of these vision-threatening retinal diseases (VTRDs) among Medicare beneficiaries. Methods: Medicare Current Beneficiary Survey data linked with Medicare Fee-for-Service claims data from 2006 to 2018 were used in a nationally representative retrospective pooled cross-sectional population-based comparison study. Outcomes between community-dwelling beneficiaries with nAMD (n = 1228), DME (n = 101), or RVO (n = 251) were compared with community-dwelling beneficiaries without any VTRDs (n = 104 088), controlling for baseline demographic and clinical differences. Beneficiaries with a diagnosis of nAMD, DME, or RVO during the data year were included; those with other VTRDs were excluded. Outcomes included vision function and loss, overall functioning as assessed by difficulties with activities of daily living (ADLs) and instrumental ADLs (iADLs), anxiety/depression, falls, and fractures. Results: In patient cohorts with nAMD, DME, and RVO, approximately one-third (34.2%-38.3%) reported "a little trouble seeing" (vs 28.3% for controls), and 26%, 17%, and 9%, respectively, reported "a lot of trouble seeing/blindness" (vs 5% of controls). Difficulty walking and doing heavy housework were the most reported ADLs and iADLs, respectively. Compared with those without VTRDs, beneficiaries with nAMD had higher odds of diagnosed vision loss (odds ratio [OR], 5.39; 95% confidence interval, 4.06-7.16; P < .001) and difficulties with iADLs (odds ratio, 1.41; 95% confidence interval, 1.11-1.80; P = .005); no differences were observed for DME or RVO vs control. After adjusting for age, sex, race/ethnicity, poverty status, comorbidities, and other relevant covariates, nAMD, DME, and RVO were not significantly associated with anxiety/depression, falls, or fractures. Discussion: Patients with nAMD or DME were more likely to report severe visual impairment than those without VTRDs, although only those with nAMD were more likely to be diagnosed with vision loss. Conclusions: Patients with nAMD continue to experience more vision impairment and worse functional status compared with a similar population of Medicare beneficiaries despite availability of therapies like antivascular endothelial growth factor to treat retinal disease. Competing Interests: V.G., A.M., C.D.N., and I.M.A. are employees of Genentech, Inc. G.O., J.B., and D.B. have consultancies with Genentech, Inc. F.S.A. has consultancies with Allergan/AbbVie, Apellis, EyePoint, Genentech, Inc., and Regeneron and is on the speakers’ bureau of Apellis. A.M.K. has consultancies with 4D Molecular Therapeutics, AbbVie, Adverum, Aerie, Aldebaran, Allergan, Apellis, Applied Genetics Technologies Corporation, Arrowhead, Aviceda, Bausch + Lomb, Broadwing Bio, Clearside, Exegenesis Bio, EyePoint, Frontera, Genentech, Inc., Gyroscope, iLumen, Iveric Bio, Janssen, Kartos, Kato, Kodiak Sciences, Kriya, Nanoscope, Notal, Novartis, Ocular Therapeutix, Oculis, OcuTerra, Olives Bio, Opthea, Oxurion, Perfuse, PolyPhotonix, Protagonist, Ray Therapeutics, RecensMedical, Regeneron, Regenxbio, RevOpsis, Roche, Stealth, Thea, Unity, Vanotech, and Vial; has received funding and grants from 4D Molecular Therapeutics, Adverum, Annexon, Apellis, Genentech, Inc., Gyroscope, Iveric Bio, Kodiak, Neurotech, NGM Bio, Novartis, Ocular Therapeutix, Oculis, OcuTerra, Opthea, Oxurion, Regenxbio, Roche, and Unity; and reports stock ownership or options in RevOpsis. X.Z. and A.N. are employee of IQVIA. T.B. and K.W. were employees of IQVIA at the time of the study
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu