Economic Burden of Diabetic Macular Edema: Research Reveals Significant Costs and Utilization

Strategic Insights -

Diabetic macular edema (DME), a leading cause of blindness, requires costly treatment with anti-vascular endothelial growth factor (VEGF) agents. However, a recent retrospective cohort study has estimated the long-term patient-centered economic burden of DME, revealing significant costs and utilization compared to those with diabetes mellitus (DM) without DME. The study used data from 1,903,603 patients and found that total costs over 3 years were 2.09 times higher for patients with DME, with reimbursement costs, nonreimbursement costs, out-of-pocket costs, and costs covered by insurance also significantly higher.

Key Takeaways:

  • The economic burden of DME was significantly higher than that of DM, with total costs over 3 years being 2.09 (95% CI 1.78-2.47) times higher.
  • Reimbursement costs were 1.89 (95% CI 1.57-2.28) times higher in the group with DME than with the group with DM, while nonreimbursement costs were 2.54 (95% CI 2.12-3.06) times higher.
  • Out-of-pocket costs and costs covered by insurance were also higher by a factor of 2.11 (95% CI 1.58-2.59) and a factor of 2.01 (95% CI 1.85-2.42), respectively.
  • Patients with DME had a significantly higher number of outpatient (1.87-fold) and inpatient (1.99-fold) visits compared with those with DM.
  • The study suggests that strategies to mitigate the economic impact of DME should include expanding anti-VEGF reimbursement criteria, approving and reimbursing cost-effective drugs, advocating for proactive eye examinations, and embracing early diagnosis by ophthalmologists facilitated by cutting-edge methodologies such as artificial intelligence for patients with DM.

Statistics:

  • Total costs over 3 years for patients with DME were 2.09 (95% CI 1.78-2.47) times higher than for those with DM.
  • Reimbursement costs for patients with DME were 1.89 (95% CI 1.57-2.28) times higher than for those with DM.
  • Nonreimbursement costs for patients with DME were 2.54 (95% CI 2.12-3.06) times higher than for those with DM.
  • Out-of-pocket costs for patients with DME were 2.11 (95% CI 1.58-2.59) times higher than for those with DM.
  • Costs covered by insurance for patients with DME were 2.01 (95% CI 1.85-2.42) times higher than for those with DM.
  • Patients with DME had 1.87-fold more outpatient visits than those with DM.
  • Patients with DME had 1.99-fold more inpatient visits than those with DM.

Sources:

  • Seoul National University College of Medicine Reports Findings in Diabetes Mellitus (Patient-Centered Economic Burden of Diabetic Macular Edema: Retrospective Cohort Study). Information Technology Newsweekly. October 22, 2024; p 645.
  • Patient-Centered Economic Burden of Diabetic Macular Edema: Retrospective Cohort Study. JMIR Public Health and Surveillance, 2024;10.