Examining the Opportunity Costs Due to Diabetic Macular Edema Taking Into Account Access Barriers Evaluated in the Barometer Program Survey in Colombia
Author(s)
Claudia López-Cabra, MD, MSc1, Ángela Daniela Rodríguez, BEc, MSc2, Diana Smith Lopez, BEc, MSc2, Oscar Andres Peñuela, MD, MSc1, Juliana Nuñoz, MD, Ophthalmologist1, Shirley Monsalve, Especialist1, wilson Mayorga Mogollon, BEc, MSc2.
1Bayer, Bogotá, Colombia, 2Numeris, Bogotá, Colombia.
1Bayer, Bogotá, Colombia, 2Numeris, Bogotá, Colombia.
OBJECTIVES: To calculate the costs related to access barriers for Diabetic Macular Edema (DME) patients over a two-year period (2022/2023), based on data from “International Market Research Survey focusing on the management and treatment of diabetic retinopathy (DR) — with and without diabetic macular edema (DME)”, which included Colombia.
METHODS: 325 patients were included in Colombia. Access barriers were classified as follows: geographic (costs related to distance to treatment facility); adherence to treatment; and affordability (treatment financing). Three types of treatments were considered: anti-VEGF injections, corticosteroids and laser therapy, with their treatment schemes. Average transportation costs were adjusted for residence area. Fees, copayments and costs of procedures and services for anti-VEGF injection treatment were derived from SISPRO-PILA, SISPRO-RIPS and other secondary sources. The medical follow-up frequency requirements were adapted to each treatment. All values were updated to 2024 based on the Consumer Price Index (CPI).
RESULTS: An exchange rate of COP$4.061 Colombian pesos per US dollar (USD) was used. Marginal costs, understood as additional costs paid by patients or health system due to barriers to access, were USD$668.031 for 2 years period (USD$10.742 per patient). By each access barrier, cost for 2 years were: geographic barrier costed USD$20.678 (USD$225 per patient); the adherence barrier was USD$456.228 (USD$8.608 per patient); and the affordability barrier, was USD$191.125 (USD$1.909 per patient).
CONCLUSIONS: Additional costs paid by patients and health system due to barriers to access in DME treatment in Colombia are not due to the effectiveness of treatment, is mainly driven by adherence and affordability of treatment. If patients were adherent to treatment, the health system would save USD$8.608 per patient (55%), but structural factors make access to treatment limited. These results highlight the need for interventions aimed at reducing these barriers to make clinical outcomes effective as a treat & extend protocol.
METHODS: 325 patients were included in Colombia. Access barriers were classified as follows: geographic (costs related to distance to treatment facility); adherence to treatment; and affordability (treatment financing). Three types of treatments were considered: anti-VEGF injections, corticosteroids and laser therapy, with their treatment schemes. Average transportation costs were adjusted for residence area. Fees, copayments and costs of procedures and services for anti-VEGF injection treatment were derived from SISPRO-PILA, SISPRO-RIPS and other secondary sources. The medical follow-up frequency requirements were adapted to each treatment. All values were updated to 2024 based on the Consumer Price Index (CPI).
RESULTS: An exchange rate of COP$4.061 Colombian pesos per US dollar (USD) was used. Marginal costs, understood as additional costs paid by patients or health system due to barriers to access, were USD$668.031 for 2 years period (USD$10.742 per patient). By each access barrier, cost for 2 years were: geographic barrier costed USD$20.678 (USD$225 per patient); the adherence barrier was USD$456.228 (USD$8.608 per patient); and the affordability barrier, was USD$191.125 (USD$1.909 per patient).
CONCLUSIONS: Additional costs paid by patients and health system due to barriers to access in DME treatment in Colombia are not due to the effectiveness of treatment, is mainly driven by adherence and affordability of treatment. If patients were adherent to treatment, the health system would save USD$8.608 per patient (55%), but structural factors make access to treatment limited. These results highlight the need for interventions aimed at reducing these barriers to make clinical outcomes effective as a treat & extend protocol.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE451
Topic
Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Thresholds & Opportunity Cost
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)