CAPTURING THE FULL BURDEN OF NAMD A SOCIAL IMPACT MICROSIMULATION APPROACH
Author(s)
Karla Hernandez-Villafuerte, PhD1, Joelle A. Hallak, MS, PhD2, Foteini Tsotra, Jr., MSc3, Lulu Lee, PhD4, nikil patel, PharmD5, Platon Peristeris6, 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, 6Athens, 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, 6Athens, Greece, 7WifOR GmbH, Darmstadt, Germany.
OBJECTIVES: Evaluation approaches in neovascular age related macular degeneration (nAMD) primarily focus on clinical efficacy and healthcare costs, underestimating the societal and economic burden. nAMD affects independence, caregiver burden, productivity, mental health, and healthcare resource utilization. The Social Impact of Health Framework was applied in the nAMD Social Impact Model (SIM), capturing broader dimensions of value by incorporating socioeconomic and humanistic outcomes.
METHODS: The nAMD SIM is a patient level microsimulation model extending traditional economic evaluations by incorporating societal and system level outcomes. It simulates disease progression, capturing impacts across patients, caregivers, and the healthcare system. Treatment frequency reflects practice, with patients assigned to antiVEGF pathways based on market shares and assumptions for efficacy, discontinuation, and followup. Healthcare system effects are quantified through staff times for injections and monitoring visits, allowing assessment of healthcare system capacity implications. Geographic access is modeled using GIS based routing to estimate travel time to treatment centers. Caregiving is modeled by patient age and visual impairment and proxied through appointment accompaniment. Mental health outcomes and productivity losses are included. Inputs are obtained from clinical evidence, real world data, and literature.
RESULTS: In the USA, over lifetime, patients diagnosed at ages 75 to 84 (55% of cases) incur $15,752 per patient in unpaid productivity losses, while those aged 65 to 74 (21.6%) incur $45,334 in combined unpaid and paid productivity losses. Caregiver losses amount to $16,945 and $26,792 per patient for the 75 to 84 and 65 to 74 groups, respectively, reflecting increased dependency. Healthcare system burden equals 69 hours and 110 hours per patient. At the population level (222,000 annual cases), representing a substantial aggregate burden.
CONCLUSIONS: The SIM quantifies the broader burden of nAMD including productivity, caregiver, mental health, and healthcare system impacts. This approach supports more comprehensive decision making when evaluating the full value of innovative treatments.
METHODS: The nAMD SIM is a patient level microsimulation model extending traditional economic evaluations by incorporating societal and system level outcomes. It simulates disease progression, capturing impacts across patients, caregivers, and the healthcare system. Treatment frequency reflects practice, with patients assigned to antiVEGF pathways based on market shares and assumptions for efficacy, discontinuation, and followup. Healthcare system effects are quantified through staff times for injections and monitoring visits, allowing assessment of healthcare system capacity implications. Geographic access is modeled using GIS based routing to estimate travel time to treatment centers. Caregiving is modeled by patient age and visual impairment and proxied through appointment accompaniment. Mental health outcomes and productivity losses are included. Inputs are obtained from clinical evidence, real world data, and literature.
RESULTS: In the USA, over lifetime, patients diagnosed at ages 75 to 84 (55% of cases) incur $15,752 per patient in unpaid productivity losses, while those aged 65 to 74 (21.6%) incur $45,334 in combined unpaid and paid productivity losses. Caregiver losses amount to $16,945 and $26,792 per patient for the 75 to 84 and 65 to 74 groups, respectively, reflecting increased dependency. Healthcare system burden equals 69 hours and 110 hours per patient. At the population level (222,000 annual cases), representing a substantial aggregate burden.
CONCLUSIONS: The SIM quantifies the broader burden of nAMD including productivity, caregiver, mental health, and healthcare system impacts. This approach supports more comprehensive decision making when evaluating the full value of innovative treatments.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE263
Topic
Economic Evaluation, Methodological & Statistical Research, Study Approaches
Topic Subcategory
Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)