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F. Yu, A.L. Coleman; Eye–Related Medicare Cost for Patients With Age–Related Macular Degeneration in the Elderly Population From 1995 to 1999 . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1964.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To explore the eye–related Medicare costs in a 5–year period for Medicare patients diagnosed with age–related macular degeneration (AMD). Methods: All patients who were coded with neovascular AMD (ICD–9: 362.52) and non–neovascular AMD (ICD–9: 362.50, 362.51, 362.57) in 1995 were extracted from a 5% random sample of Medicare databases (Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Part B Files and Denominator Files). A control group was selected, including patients coded with blepharitis (ICD–9: 373.0x), chronic conjunctivitis (ICD–9: 372.1x) or blepharoconjunctivitis (ICD–9: 372.2x). Patients were excluded if they were under 65 years of age, did not reside in the 50 United States or the District of Columbia, did not have Part–B coverage, had HMO coverage that was not processed by CMS, or lacked follow–up information. Any eye–related Medicare claims from 1995 to 1999 were then evaluated for both AMD and control patients. Kruskal–Wallis–Wilcoxon tests were used to assess the difference in the average cost among neovascular AMD, non–neovascular AMD, and control patients. Multiple linear regression models were also performed by adjusting for potential baseline risk factors including age, gender, race, CMS region of residence, and indicators for the presence of primary open–angle glaucoma, cataract, hypertension, cardiac vascular disease, diabetes, or hyperlipidemia. Results: In 1995, 8,237 patients were coded for neovascular AMD, 69,029 were coded for non–neovascular AMD, and 31,486 were coded for blepharitis, chronic conjunctivitis, or blepharoconjunctivitis. Among 77,986 (72%) of patients who were followed through 1999, mean ± SD of the 5–year total allowed reimbursement ($) for eye related visits was 2,353 ± 2,411 (median=1,598) for neovascular AMD patients, 1,539 ± 1,822 (median=785) for non–neovascular AMD patients, and 1,428 ± 1,752 (median=658) for control patients (p<0.001). After adjusting for potential confounders, both neovascular AMD (Cost ratio=1.99; 95% CI: 1.92, 2.06; p<0.001) and non–neovascular AMD patients (Cost ratio=1.13; 95% CI: 1.11, 1.15; p<0.001) spent more on eye–related visits over 5 years. Conclusions: From 1995 to 1999, Medicare costs for eye–related visits by patients diagnosed with neovascular AMD and non–neovascular AMD are greater than for patients diagnosed with blepharitis/conjunctivitis. The difference between neovascular AMD and blepharitis/conjunctivitis patients is projected to be roughly $30 million per year, which can be used to judge the potential cost savings of preventive measures against AMD.
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