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G. Kobelt, B. Richard, C. Plesnilla, P. Buchholz, A. Brezin, E. Heron, M. Labetoulle, J. Sahel, B. Bodaghi; Evaluation of the Cost of Uveitis Treatment: One Year Analysis From a Retrospective Chart Review in France. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4985.
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To evaluate current treatment strategies and one year consumption of health care resources for patients with uveitis in France.
Four referral centers included 100 consecutive patients (>18 years) with 12 months follow-up after the first visit at the center. Data were abstracted from the patient charts and included basic demographic data, a limited number of clinical parameters to characterize patients and all disease- or treatment-related resource consumption. Direct health care costs were estimated using publicly available standard unit cost. Indirect costs were based on standard sick-leave for each type of inpatient admission or outpatient intervention and a gender-specific cost of employment.
The mean age of the patients was 46 years (21-87), and a majority (82%) was below retirement age (60 years). Patients’ disease could be divided into the following categories: posterior uveitis (36%), panuveitis (33%), chronic anterior (24%) and intermediate (7%). About half of the patients (49%) had bilateral disease. One fifth of patients had a vision below 20/200, however over 40% had 20/40 and better. Ocular co-morbidity was present in 66% of patients (e.g. 23% ME). 84% had a diagnosis of associated autoimmune disease. Mean direct costs per patient over 12 months were €3403 ($5045). During follow-up 91% of patients were treated with drugs, while 8% received an injection (triamcinolone or dexamethasone) and 2% had laser treatment. The largest part of costs could be attributed to inpatient stays with a mean cost of €2889 ($4283) per year. 62 patients were admitted on average 1.7 times, while 33 patients were admitted 1.9 times for the day. The average productivity loss was estimated at €1750 ($2594) for those patients below 60 years with an admission or intervention, leading to a mean indirect cost of €830 ($1230) per patient in the sample. The total annual costs per patient are thus estimated at a minimum of €4230 ($6271).
Annual treatment costs in this sample are driven by frequent and fairly long inpatient stays, due most likely to the fact that these specialized centers see patients with more severe disease. Furthermore, in the current sample, most patients were of working age, which also suggests a substantial amount of indirect costs arising from sick leave.
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