OBJECTIVES:

Geographic atrophy (GA) is an advanced form of age-related macular degeneration that can lead to irreversible visual impairment (VI) and blindness. This study quantified the cost burden of GA and GA progression to VI or blindness.

METHODS:

This retrospective cohort study used data from the Optum® Clinformatics® Data Mart (01/2016–09/2021). Medicare Advantage patients were grouped into four mutually exclusive cohorts based on their ICD diagnoses: no GA, with GA only, with GA and VI (GA+VI), and with GA and blindness (GA+B). Index dates were set at the 12 months after eligibility start for GA and no-GA patients or the later of 12 months after eligibility start or the diagnosis date of VI/blindness for GA+VI and GA+B patients. The 12 months prior to the index date defined the baseline. Follow-up spanned from the index date to the earlier of end of eligibility or data availability. Mean all-cause healthcare costs were assessed per-patient-per-year (PPPY) and compared between GA only and no-GA cohorts as well as GA+VI and GA+B vs GA only using cost differences with inverse probability treatment weighting.

RESULTS:

Patients with no GA (N=72,476), GA only (N=18,199), GA+VI (N=2,285), and GA+B (N=1,716) had a mean age between 74 and 85 years, and majority were female (59%-72%). Relative to no-GA patients, GA patients had significantly higher all-cause total healthcare costs PPPY (cost difference [95% confidence interval (CI)]: $1,171 [$204, $2,138]). Relative to GA patients, patients with GA+VI and GA+B had significantly higher all-cause total healthcare costs PPPY (cost difference [95% CI]: $5,096 [$2,811, $7,381] and $9,952 [6,172, 13,733], respectively). The main drivers of these cost differences were hospitalization and outpatient visits.

CONCLUSIONS:

The cost burden of GA is substantial and increases significantly as GA patients further develop VI or blindness. Early treatment may mitigate healthcare costs related to disease progression.