OBJECTIVES: Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness in people older than 50 years affecting 8% of the French population, with a frequency increasing with age. Diabetic macular edema (DME) is a form of diabetic retinopathy, affecting 10% of the diabetic population. Anti-VEGF injections are currently the main treatment of AMD and DME. The objective of this approach was to estimate the societal cost of these two pathologies and to identify its main determinants.

METHODS: To estimate the societal costs of both AMD and DME, we conducted a pragmatic review of the French and European literature published between 2008 and 2022. Data from the literature were extracted using a standardized grid. We used both the replacement cost & opportunity cost methods to estimate informal care cost related to anti-VEGF injections

RESULTS: Of the 40 articles selected from the literature, based on title and abstract, seven met the inclusion criteria, two on DME and five on AMD, two of which used French data. No study specific to neovascular-AMD was identified.

The annual societal cost per patient of AMD (DME) was estimated at €29,997 (€15,841). For AMD, the annual cost of informal help was €1,119, anti-VEGF injection requiring 3.6 hours of caregiver time. The hourly cost of informal assistance related to injections was valued between €39.6 (replacement cost method) and €44.6 (opportunity cost method). For AMD (DME) patient out-of-pocket was estimated at 2,139€ (706€) per year.

CONCLUSIONS: This study allowed to estimate AMD/DME societal cost. For AMD, these costs imply significant out-of-pocket expense for patients and their families. Reducing the frequency of anti-VEGF injections, by decreasing the costs of transport and informal assistance, could lower this remaining expense. An ongoing study based on the SNDS will enable to describe more accurately the HCRU in these pathologies.