OBJECTIVES : Geographic atrophy (GA), or advanced dry age-related macular degeneration (AMD), is associated with a substantial decline in vision-related quality of life and economic burden, with no current treatments available. This study assessed the healthcare resource utilization (HCRU) and direct costs among patients with GA, stratified by severity.

METHODS : Patients ≥50 years of age with a prevalent GA diagnosis were classified by disease severity and identified between October 1, 2016 and June 30, 2017 using ICD-10-CM diagnoses recorded in IQVIA’s PharMetrics Plus database. Patients were continuously enrolled for ±12 months from the index date. All-cause HCRU and costs were measured during the 12-month follow-up period. Multivariable analyses were conducted to assess associations between severity levels of GA and outcomes of interest, adjusting for baseline characteristics.

RESULTS : The study included 28,773 patients (mean age 68.7y; 59% female; 78% commercially insured), of which 76% had bilateral GA. Patients were stratified into three groups of increasing disease severity: early/intermediate (EI) AMD, GA without subfoveal involvement (GAwoSF), and GA with subfoveal involvement (GAwSF). The annual mean (SD) number of visits in the outpatient, emergency department, and inpatient settings were 23.0 (19.9), 3.7 (3.7), and 12.3 (19.4), respectively, with the mean (SD) length of stay of 5.5 (3.2) days. Patients with unilateral GAwoSF had 9% more outpatient visits (rate ratio = 1.09, 95% CI = 1.01-1.18) and higher odds of a fracture (odds ratio = 1.553, 95% CI = 1.076-2.242) than those with unilateral EI AMD. No significant differences in cost were observed among more severe GA patients.

CONCLUSIONS : This is the first study to characterize GA patients by severity. Results show high utilization of resources, particularly with more severe GA, indicating significant unmet medical need in these patients. Further research exploring the contributing factors to the economic and long-term burden of GA is warranted.