Direct medical costs of age-related macular degeneration in Italian hospital ophthalmology departments. A multicenter, prospective 1-year study.

This study calculated the resource utilization and direct medical costs related to age-related macular degeneration (AMD). We conducted a multicenter observational study in 1999 in seven hospital ophthalmology departments in northern and central Italy. A total of 476 patients aged over 50 years with the diagnoses were classified into three prognostic groups: (a) drusen (23.7%), (b) geographic atrophy (16.4%), and (c) retinal changes associated with choroidal neovascularization (CNV) (59.9%). In addition to the costs reimbursed by the Italian National Health Service, we estimated also patients' out of pocket expenses. The mean cost per patient per year was 383.2 euro; patients with CNV were by far the most costly (540.1 euro, vs. 158.1 euro for drusen and 147.9 euro for geographic atrophy). Hospital costs and diagnostics were the main cost determinants. Services directly paid for by patients (private consultations and OTCs) amounted to 46.5 euro for patients with CNV, 50.3 euro for drusen, and 68.8 euro for geographic atrophy. The major finding of the study was that the presence of CNV involved higher expenditure than drusen or geographic atrophy. This suggests that the costs of AMD rise significantly with the severity of the illness.