OBJECTIVES: To assess the incremental healthcare costs associated with ME among patients with NIU in the US.

METHODS: Commercially insured adult patients with ≥2 diagnoses of NIU on distinct dates were identified using the IBM MarketScan® database (10/2015-12/2019). Patients with NIU were classified into mutually exclusive cohorts based on whether or not they had an observed diagnosis of ME at any time. Healthcare costs (2020 USD) were described over their most recent 12 months of continuous health plan enrollment.

RESULTS: A total of 34,651 patients with NIU were identified. Although ME is likely underreported in claims data, 3,130 (9.0%) of patients had an observed ME diagnosis. Patients with and without ME, respectively, had a mean age of 50.2 and 47.5 years and 59.5% and 58.5% were female. Patients with ME incurred 24% higher costs compared to those without ME ($20,463 vs $16,444; Δ=$4,019[$2,304-$5,733]; p<0.001), where the difference was mainly driven by increased outpatient and pharmacy costs. Further, among patients with ME, a higher proportion received NIU-related treatment during the 12-month study period compared to those without ME (38.8% vs 26.0%). Among patients with ME who received NIU-related treatment during the study period, mean total costs were $22,707. In addition, although no treatment is currently approved for ME associated with NIU, a higher proportion of patients with ME received an intraocular injection (IOI) during the study period compared to those without ME (29.6% vs 2.3%). Among those with ME who received IOI, mean total costs were $25,426. Finally, ME affecting both eyes (bilateral ME; 47.6%) was associated with higher total costs ($28,317) compared to unilateral ME (52.4%; $22,510).

CONCLUSIONS: ME is associated with a substantial economic burden among patients with NIU, and is particularly high among patients receiving NIU-related treatment, including IOI treatment, or those with bilateral disease.