Product information and disease description Place of product in therapy Disease description Burden of Wet age-related macular degeneration

Economic impact of Wet age-related macular degeneration on families

9 evidence topics · 7 sources

Summary: economic impact on families

Caregivers of people receiving anti-VEGF therapy carry a documented time and cost burden. In a UK survey of 250 patient-caregiver pairs, 70.8% of caregivers had attended 10 or more appointments in the previous year, 24.8% required time off work, and caregivers reported loss of income as a consequence. In a US time-and-motion study, caregivers took time away from work (22%) and personal activities (28%) to provide transportation. In a nine-country survey, 56.7% of 910 participants were usually taken to appointments by a caregiver, and a caregiver being unable to take the patient was the most common reason for a missed appointment (25.9%). In a US societal cost survey, direct nonmedical costs, primarily caregiver costs, made up 67.1% of societal ophthalmic costs in participants with visual loss.

Caregiver costs as a share of societal costs

“Direct nonmedical costs, primarily caregiver, comprised 67.1% of Study Cohort societal ophthalmic costs, versus 21.3% ($1,302/$6,116) of Control Cohort costs (P < 0.001) and 74.1% of 20/800 to no light perception subcohort costs.” (opens the source at this quote in a new tab)

Caregiver time away from work for transportation to appointments

“Patients stated that caregivers took time away from work (22%) and personal activities (28%) to provide transportation to appointments.” (opens the source at this quote in a new tab)

Caregiver burden during ranibizumab therapy: UK survey

“This is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom.” (opens the source at this quote in a new tab)
“The most common eye-related care activity undertaken was accompanying patients for their eye clinic appointments, with 70.8% carers having attended ≥10 appointments over the last year. On an average, the caregivers reported that 70% spent at least half a day and 43.6% spent most of the day assisting their patient with their clinic visit every 4–6 weeks. 24.8% of caregivers required time off work to support patients with their eye treatment, and 10% of them reported that this led to a loss of income.” (opens the source at this quote in a new tab)
“Ranibizumab therapy for nAMD is associated with significant caregiver burden. Both disease impact and treatment frequency contributed to the overall burden.” (opens the source at this quote in a new tab)

Escorts to injection visits and missed appointments: nine-country survey

“The majority of patients (82.1%; n=747/910) received support from a caregiver.” (opens the source at this quote in a new tab)
“Most caregivers always attended appointments (60.1%; n=535/890)” (opens the source at this quote in a new tab)
“For the 15.7% (n=143/910) of patients who missed a clinic appointment, the main obstacles were that the caregiver was unable to take them to the appointment (25.9%; n=37/143), fear about receiving an injection (21.0%; n=30/143), and patient illness (reason not stated) (18.9%; n=27/143).” (opens the source at this quote in a new tab)
“Most patients (56.7%; n=516/910) were usually taken to the appointment by a caregiver; however, 20.4% (n=186/910) went by public transport, 12.4% (n=113/910) drove themselves, 8.1% (n=74/910) used a taxi, and 2.3% (n=21/910) were taken by an ambulance.” (opens the source at this quote in a new tab)
“Other barriers included treatment costs (27.8%; n=253/910)” (opens the source at this quote in a new tab)

Caregiver distress and respite

“Most caregivers were family caregivers and were found to be compassionate and self-sacrificing. They accepted additional responsibility whilst providing an encouraging environment for their care recipient. As a result, they experience distress and consider their own needs as secondary. Very few seek or receive respite and this added burden can have a negative impact upon the relationship between caregiver and care recipient.” (opens the source at this quote in a new tab)

Who transports patients to injection visits: US time-and-motion survey

“The majority of patients (72%, 54 of 75) were driven to their appointment by a caregiver. Their caregiver was a spouse or partner (65%, 35 of 54), an adult child or grandchild (22%, 12 of 54), a friend (7%, 4 of 54), or another person (6%, 3 of 54).” (opens the source at this quote in a new tab)
“Twenty percent (15 of 75) of patients drove themselves, while 8% (6 of 75) took a car service or public or government transportation.” (opens the source at this quote in a new tab)

Out-of-pocket transportation costs and household income of participants

“Few patients experienced direct out-of-pocket transportation costs. Eighty-nine percent (67 of 75) reported that they did not pay any transportation costs for their latest clinic visit. Among those who had out-of-pocket transportation cost, 12% (8 of 67) paid for parking, 6% (4 of 67) paid tolls, and 3% (2 of 67) paid bus fare.” (opens the source at this quote in a new tab)
“The average income was $40 000. The majority of patients (62%, 46 of 75) reported an income of less than or equal to $50 000.” (opens the source at this quote in a new tab)

Composition of caregiver costs and employment effects of severe vision loss

“Direct nonmedical, or caregiver, costs included 27% for paid caregivers and 73% for unpaid caregivers,” (opens the source at this quote in a new tab)
“Inside activities of daily living costs comprised 50% of caregiver costs.” (opens the source at this quote in a new tab)
“Those with severe difficulty seeing (<20/200), however, earned a median $2,564 per month (98% that of a nondisabled person) but were only 47% as likely to be employed as people without disabilities.” (opens the source at this quote in a new tab)