OBJECTIVES: Diabetic Macular Edema (DME) and neovascular Age-related Macular Degeneration (nAMD) cause vision loss leading to morbidity and loss of health-related quality of life. Treatment in the country is based on laser (public market) and anti-vascular endothelial growth factor (VEGF) (private market). Our objective is to estimate the economic burden generated by these diseases in Panama to have information that allows decision-makers to estimate the magnitude of this problem in the country.

METHODS: A bottom-up cost analysis was performed with ophthalmology and retinology experts from the country. Experts differentiated resources of the public and private healthcare systems and the costs of each one. A list of the most used health resources (identified from the scientific literature) was evaluated with each expert in the care of these patients, calculating the probability and frequency of their use; finally, every expert identified the differences in healthcare processes, avoiding the halo effect. Finally, the costs (USD 2023) from the tariff manuals and those reported by the experts were taken to build the model.

RESULTS: The average annual cost of healthcare for a patient with DME in Panama is $18,725, 67% of which are indirect costs (a health caregiver and sickness pension for vision loss). The average annual cost of healthcare for a patient with nAMD in Panama is $16,288, 77% of which are indirect costs (a health caregiver and sickness pension for vision loss). Patients with DME and nAMD are treated in the public health system with laser only, while patients in the private health system receive treatment with laser and anti-VEGF.

CONCLUSIONS: The annual cost of patients with DME and nAMD in Panama fluctuates between $16,288 and $18,725, and approximately 70% of them are due to health caregivers and sickness pensions for vision loss.