OBJECTIVES: We aimed to analyze economic burden of patients with exudative age-related macular degeneration (eAMD) in South Korea.

METHODS: This study is a single center cohort study using Observational Medical Outcome Partners-Common Data Model in Seoul National University Bundang hospital. Treatment group was defined as patients with eAMD diagnosis by ophthalmologist and anti-vascular endothelial growth factor or verteporfin between August 1, 2009, and July 31, 2017. The control group was patients who visited the hospital for any diagnoses, but not eAMD in the same period. We excluded cancer patients in both groups. Propensity score matching was performed by LASSO in ATLAS. To estimate economic burden, we used exponential conditional model (ECM) with log link function and gamma family distribution. For covariates, we included dummy variable for eAMD group, demographic data, pre-index cost, and unbalanced covariates in propensity score model. Outcomes were total medical cost, reimbursement cost, non-reimbursement cost, and out-of-pocket expense for two years.

RESULTS: After 1:4 propensity score matching, there were 783 patients in eAMD group and 2,918 in non-eAMD group. Total medical cost estimated by ECM was $4,671 in eAMD group and $1,293 in non-eAMD group in first year. In the second year, total medical cost was $2,603 in eAMD group and $1,080 in non-eAMD group. Compared to non-eAMD group, total medical costs in eAMD group were 3.56 times and 2.64 times higher in first year and second year, respectively. Reimbursement cost, and non-reimbursement cost were also higher in eAMD group. In eAMD group, out-of-pocket expense was $1,230 in first year and $856 in the second year.

CONCLUSIONS: Economic burden for patients with eAMD was higher than that with non-eAMD for two years in South Korea. As eAMD is a severe intractable disease that can progress to blindness with high burden of disease, management strategy for eAMD patients is needed.