THE HIDDEN ECONOMIC AND HEALTHCARE BURDEN OF NAMD IN THE USA AND GERMANY EVIDENCE FROM A 20-YEAR SOCIAL IMPACT MODEL
Author(s)
Karla Hernandez-Villafuerte, PhD1, Joelle A. Hallak, MS, PhD2, Foteini Tsotra, Jr., MSc3, Lulu Lee, PhD4, nikil patel, PharmD5, Platon Peristeris, PhD6, Omar Jouini, MSc7, Eric Hillson, PhD5, Malina Müller, BA, MA, PhD1, Joice T. Huang, PharmD4.
1WifOR Institute, Darmstadt, Germany, 2Associate Director, RWE, HEOR, AbbVie, Chicago, IL, USA, 3Laboratory of Health Economics & Management, University of Piraeus, Athens, Greece, Athens, Greece, 4AbbVie, Irvine, CA, USA, 5AbbVie, Chicago, IL, USA, 6WifOR Institute, Athens, Greece, 7WifOR GmbH, Darmstadt, Germany.
1WifOR Institute, Darmstadt, Germany, 2Associate Director, RWE, HEOR, AbbVie, Chicago, IL, USA, 3Laboratory of Health Economics & Management, University of Piraeus, Athens, Greece, Athens, Greece, 4AbbVie, Irvine, CA, USA, 5AbbVie, Chicago, IL, USA, 6WifOR Institute, Athens, Greece, 7WifOR GmbH, Darmstadt, Germany.
OBJECTIVES: Neovascular age related macular degeneration (nAMD) is a cause of vision loss and imposes clinical and socioeconomic burden. Current standard of care antiVEGF treatment requires frequent clinic visits and intravitreal injections, creating demands on patients, caregivers, and healthcare systems. These repeated appointments increase travel and time burden, may negatively affect mental health, and place growing pressure on ophthalmology services. Despite ongoing treatment, many patients continue to experience progressive vision decline. We quantified the long-term societal burden of nAMD in the USA and Germany using a Social Impact Model evaluating impacts across productivity, healthcare system, transportation, caregiving, and mental health.
METHODS: A patient level microsimulation model was developed to estimate the socioeconomic impact over 20 years. It incorporated clinical outcomes, healthcare resource utilization, transportation, productivity losses for patients and caregivers, and mental health-related impacts associated with anxiety and depression, associated with visual impairment. National level projections were generated using incidence estimates (USA 222k and Germany 58k patients annually) and demographic trends. Productivity losses were valued using Gross Value Added estimates for paid and unpaid work.
RESULTS: In the USA, productivity losses from appointments and transportation were estimated at USD 49.3 billion (62% paid; 38% unpaid work), while Germany incurred losses of USD 11.2 billion (58% paid; 42% unpaid work), reflecting increasing dependency. Mental health-related productivity losses added USD 213.9 billion and USD 50.0 billion, respectively. These losses represented 0.78% of US GDP and 0.16% of German GDP. Healthcare system burden was substantial, requiring an estimated 201.5 million healthcare staff hours in the USA and 46.9 million hours in Germany, equivalent to 4,318 and 1,040 full-time healthcare professionals, respectively, over 20 years.
CONCLUSIONS: nAMD generates a profound societal and healthcare burden extending beyond vision impairment. More durable treatment that reduce appointment frequency whilst improving clinical outcomes could relieve pressure on patients, caregivers, and healthcare systems.
METHODS: A patient level microsimulation model was developed to estimate the socioeconomic impact over 20 years. It incorporated clinical outcomes, healthcare resource utilization, transportation, productivity losses for patients and caregivers, and mental health-related impacts associated with anxiety and depression, associated with visual impairment. National level projections were generated using incidence estimates (USA 222k and Germany 58k patients annually) and demographic trends. Productivity losses were valued using Gross Value Added estimates for paid and unpaid work.
RESULTS: In the USA, productivity losses from appointments and transportation were estimated at USD 49.3 billion (62% paid; 38% unpaid work), while Germany incurred losses of USD 11.2 billion (58% paid; 42% unpaid work), reflecting increasing dependency. Mental health-related productivity losses added USD 213.9 billion and USD 50.0 billion, respectively. These losses represented 0.78% of US GDP and 0.16% of German GDP. Healthcare system burden was substantial, requiring an estimated 201.5 million healthcare staff hours in the USA and 46.9 million hours in Germany, equivalent to 4,318 and 1,040 full-time healthcare professionals, respectively, over 20 years.
CONCLUSIONS: nAMD generates a profound societal and healthcare burden extending beyond vision impairment. More durable treatment that reduce appointment frequency whilst improving clinical outcomes could relieve pressure on patients, caregivers, and healthcare systems.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE121
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Methodological & Statistical Research
Topic Subcategory
Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
Mental Health (including addiction), Sensory System Disorders (Ear, Eye, Dental, Skin)