Cost-Effectiveness Model for Age-Related Macular Degeneration: Comparing Early and Late Macugen ® Treatment

Population-based studies across developed countries have estimated the prevalence rate of late age-related macular degeneration (AMD) to be between 1.7 and 1.9 per 100 individuals.1 By the year 2020, almost 3 million individuals will suffer from AMD in the United States alone.2 The resulting visual impairment affects patient quality of life as much as arthritis, asthma, diabetes, and stroke.3 The economic burden of AMD is high because people with impaired vision due to AMD may experience an increased risk of falls and fractures, depression, and the need for daily support services or nursing home care. In Europe, per-patient direct medical costs associated with AMD management have been estimated to be between approximately €11,000 and €13,000 per year.4 Macugen ® (pegaptanib sodium) is the first pharmacological treatment for subfoveal neovascular AMD that helps slow the progression of the disease and that improves visual acuity for some patients.5 It has been suggested that early treatment of AMD may limit choroidal neovascularization-induced damage to photoreceptors and/or the retinal pigment epithelium and so be associated with better vision results.6 Such improved results also may be associated with reduced resource use. To develop a comprehensive economic model comparing the cost-effectiveness of treatment with Macugen and usual care in patients with AMD with less severe visual acuity (early) and more severe visual acuity (late