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

Humanistic burden and health-related quality of life

9 evidence topics · 9 sources

Summary: humanistic burden

Time trade-off utility values in participants with AMD decline with visual acuity in the better-seeing eye, from 0.89 at 20/20 to 20/25 to 0.40 at counting fingers to light perception (80 participants); participants in the lowest visual acuity group were willing to trade 60% of remaining lifetime for perfect vision. National Eye Institute Visual Function Questionnaire-25 mental health subscale scores were lowest in participants with visual acuity of 20/200 or worse (median 43.8). Among 130 participants in a Norwegian survey, 33.1% reported stress in the week before an injection and 54.6% described the injection as uncomfortable.

Utility values by visual acuity in the better-seeing eye

Visual acuity in the better-seeing eye	Time trade-off utility (95% CI)
Group 1: 20/20 to 20/25	“0.89 (95% CI, 0.82-0.96)”
Group 2: 20/30 to 20/50	“0.81 (95% CI, 0.73-0.89)”
Group 3: 20/60 to 20/100	“0.57 (95% CI, 0.47-0.67)”
Group 4: 20/200 to 20/400	“0.52 (95% CI, 0.38-0.66)”
Group 5: counting fingers to light perception	“0.40 (95% CI, 0.29-0.50)”

Time trade-off: lifetime traded for perfect vision

“Thus, those patients in group 1 were willing to trade 11% of their remaining lifetime in return for perfect vision in each eye, whereas those in group 5 were willing to trade 60% of their remaining lifetime in return for perfect vision in each eye.” (opens the source at this quote in a new tab)
“Age-related macular degeneration causes a substantial decrease in patient utility values and is highly dependent on the degree of visual loss in the better-seeing eye.” (opens the source at this quote in a new tab)

Vision-related quality of life and mental health by visual acuity

“Eight hundred seventy-five patients were included in the study.” (opens the source at this quote in a new tab)
“When stratified by VA, patients with a habitual VA of 20/200 or worse scored the lowest on mental health subscales scores: median of 43.8 (IQR: 31–62). Patients with a VA of 20/20 scored the highest: 87.5 (IQR: 81–94).” (opens the source at this quote in a new tab)

Guideline statement on quality of life

“Age-related macular degeneration is associated with depression and reduced vision-related quality of life.” (opens the source at this quote in a new tab)
“Early detection and treatment of AMD to arrest the deterioration in vision may help preserve patients’ quality of life and independence.” (opens the source at this quote in a new tab)

Emotional burden of intravitreal injections

“In total, 130 patients responded to the survey. The majority of patients reported to receive nine or more injections per year (48.8%), and many patients needed caregiver support for every treatment appointment (37.7%). Patients reported to be anxious one day (25.4%), two days (8.5%), one week (10.8%) or more than one week (3.1%) prior to treatment. The week before the treatment, 33.1% of patients reported to be stressed and 15.4% struggled to sleep. The majority of patients reported the treatment as uncomfortable (54.6%) or as somewhat painful (26.2%).” (opens the source at this quote in a new tab)

Barriers to treatment reported by patients and caregivers

“Most patients (65.4%; n=595/910) and caregivers (77.0%; n=685/890) reported a number of obstacles in managing wAMD (Figure 2). For patients, the main barrier was the treatment itself (34.8%; n=317/910)” (opens the source at this quote in a new tab)

Utility values by visual acuity used in a US cost-utility model

“Mean vision measurements in the VEGF-I cohorts and control cohorts each year were converted to utility format, ranging from a utility of 0.80 for 20/40 vision in the better-seeing eye to 0.538 associated with 20/630 vision, to calculate the yearly QALY accrual associated with therapy versus none” (opens the source at this quote in a new tab)
“The time tradeoff utilities were obtained from a visual utility database of 1,400 ophthalmic patient interviews.” (opens the source at this quote in a new tab)

Clinic time and post-injection recovery time reported by patients

“More than one-third (36%, 27 of 75) of patients reported that their most recent visit took 90 minutes or more, and 79% (59 of 75) reported spending at least 3 hours recovering following injections.” (opens the source at this quote in a new tab)