Cost of nAMD Management in 3R Level Hospitals in Spain. Comparison of Unitary Cost System Vs National Cost Database

OBJECTIVES: Economic analysis to compare across country, region on hospital usually are limited by the cost imputation to services/resources used for disease management. Compare the costs of hospital management neovascular age-related macular degeneration (nAMD) using a unitary cost model vs cost from a national cost database

METHODS: Cross sectional analysis of patients attended in two 3rd level hospitals in Spain from 2017 to 2018. Cost were calculated by a validated unitary cost system (SISCOST) and price tag of costs in the ophthalmology service. Results were compared with a published paper analyzing cost of nAMD management in five 3rd hospitals in Spain, which used cost imputation from a national cost database.

RESULTS: Patients from both studies were comparable. In our study (1.302 patients and 1.644 eyes treated) the average number of injections per patient per year was 5.15, with good visual acuity results. Mean annual cost per patient was 2.738,43€ and 2.339,63€ for patients with only one eye affected. The cost of anti-VEGF drug represents 66,38%, while tests, visits and other examinations was 33,62%. Data from the literature derived in an average of 4,8 injections (no info on visual acuity) and the annual cost per patient was 4.727€. The cost of anti-VEGF drugs represented 37,8% and test, visits and other examinations was the 52,6%.

CONCLUSIONS: Disease management cost is highly affected by methodology and specially data sources, and can lead to confuse results. The unitary cost is the preferred methodology over the cost country databases.