Healthcare resource use and costs of diabetic macular oedema for patients with antivascular endothelial growth factor versus a dexamethasone intravitreal implant in Korea: a population-based study. Issue 9 (20th September 2019)

• Record Type: Journal Article
• Authors: Cho, HyunJeong; Choi, Kyung Seek; Lee, Joo Yong; Lee, Donghwan; Choi, Nam-Kyong; Lee, YouKyung; Bae, SeungJin
• Is Part Of: BMJ open. Volume 9:Issue 9(2019)
• Publication Date: 2019-09-20
• Subjects: diabetic macular edema -- population-based study -- resource utilization -- cost of illness -- Korea -- agencies regulation; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2019-030930
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To estimate the costs and healthcare resources of patients with diabetic macular oedema (DME) who received intravitreal antivascular endothelial growth factor (anti-VEGF) agents or a dexamethasone intravitreal implant (DEX-implant) in Korea. Design: Retrospective cohort study. Setting: The Korean National Health Insurance claim data from 1 January 2015 to 30 June 2017 were retrieved from the Health Insurance Review and Assessment Service. Participants: Adult patients with DME who were diagnosed with diabetic retinopathy or DME and received ranibizumab, aflibercept or a DEX-implant in conjunction with intravitreal injection were included. Patients whose primary diagnoses were age-related macular degeneration or retinal vein occlusion were excluded. Main outcome measures: Healthcare resource utilisation and costs related to DME in the 12-month postindex period. Results: During the study period, 182 patients and 414 patients were identified in the anti-VEGF and DEX-implant groups, respectively, and there was no significant difference in the demographic characteristics between the two groups. The outpatient eye care-related medical costs were US$3002.33 for the anti-VEGF group vs US$2250.35 for the DEX-implant group (p<0.0001). After adjusting the relevant covariates based on the generalised linear model, the estimated outpatient eye care-related medical costs were 33% higher in the anti-VEGF group than in the DEX-implant group (p<0.0001, 95% CI 22% to 45%). The utilisation pattern of the two groups showed no significant difference except for the number of intravitreal injections, which was higher in the anti-VEGF group (2.69±2.29) than in the DEX-implant group (2.09±1.37, p<0.001). Conclusion: The average annual eye-related medical cost of the DEX-implant group was significantly lower than that of the anti-VEGF group during the study period, which was mainly due to decreased utilisation of eye care-related injections. Further long-term studies are needed.