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The Economics of Age-Related Macular Degeneration

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Age-related Macular Degeneration Diagnosis and Treatment

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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.

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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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Authors and Affiliations

  1. Department of Ophthalmology, Jefferson Medical College, 910 E. Willow Grove Ave., Wyndmoore, PA, 19038, USA

    Gary C. Brown M.D., M.B.A.

  2. Center for Value-Based Medicine, 6010 Mill Road, Flourtown, PA, 19031, USA

    Gary C. Brown M.D., M.B.A.

  3. Department of Ophthalmology, Jefferson Medical College, Wyndmoore, PA, USA

    Melissa M. Brown M.D., M.B.A.

  4. Center for Value-Based Medicine, Flourtown, PA, USA

    Melissa M. Brown M.D., M.B.A., Heidi B. Lieske, Philip A. Lieske & Kathryn Brown

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  1. Gary C. Brown M.D., M.B.A.
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  3. Heidi B. Lieske
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Correspondence to Gary C. Brown M.D., M.B.A. .

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Editors and Affiliations

  1. Wills Eye Hospital, Walnut St. 840, Philadelphia, 19107, Pennsylvania, USA

    Allen C. Ho

  2. Wills Eye Hospital, Walnut St. 840, Philadelphia, 19107, Pennsylvania, USA

    Carl D. Regillo

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Brown, G.C., Brown, M.M., Lieske, H.B., Lieske, P.A., Brown, K. (2011). The Economics of Age-Related Macular Degeneration. In: Ho, A., Regillo, C. (eds) Age-related Macular Degeneration Diagnosis and Treatment. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0125-4_10

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  • DOI: https://doi.org/10.1007/978-1-4614-0125-4_10

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