May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Model Cost–Benefit Study of AREDS Antioxidant Supplementation for AMD Compared to Visudyne: A Dominant Strategy?
Author Affiliations & Notes
  • J.R. Trevithick
    Biochemistry, Fac Medicine, University of Western Ontario, London, ON, Canada
  • S.C. Tomany
    Center for the Advancement of Urban Children,, Medical College of Wisconsin, Milwaukee, WI
  • Footnotes
    Commercial Relationships  J.R. Trevithick, None; S.C. Tomany, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1411. doi:
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      J.R. Trevithick, S.C. Tomany; Model Cost–Benefit Study of AREDS Antioxidant Supplementation for AMD Compared to Visudyne: A Dominant Strategy? . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1411.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: In Ontario, Canada, in a cohort of all people initially aged 50–54 years, modeling whether the Age–Related Eye Disease Study (AREDS) antioxidant supplementation for stage 3 and 4 Age–Related Macular Degeneration (AMD) would decrease costs of photodynamic treatment by Visudyne? Perspective: Third party payer, the Ontario Health Insurance Plan. Methods:Using reported risk reductions, incidence and prevalence data by age and sex from the Framingham, and Beaver Dam studies, respectively, and yearly costs: AREDS C$182.5O, potential savings were calculated as the difference and incremental cost between the estimated medical costs for the untreated cohort of C$17,000 for Visudyne treatment of individuals with neovascularization, and the same cohort if stage 3 and 4 AMD patients were treated with antioxidants, decreasing progression to neovascularization. Results:For the Ontario cohort of ca. 788,000 aged 51–55 years in 2001, for photodynamic therapy of the untreated cohort, modeled costs were C$1.7 billion for Beaver Dam prevalence C$224 million for Framingham incidence data. AREDS treatment costs would be C$513 million for Beaver Dam or C$ 85 million for Framingham. AREDS would reduce photodynamic therapy costs, a net saving C$431 million using Beaver Dam prevalence data, a savings of C$547 per person in the total cohort, or C$ 6,753 per stage 3 and 4 patient treated. Alternatively, net savings of C$70.3 million were modeled using Framingham incidence data. Quality adjusted life years (QALYs) would also be saved by AREDS antioxidant supplements: 51,979 for Framingham, or 246,592 for Beaver Dam models. Worst case modeling also showed savings for Framingham incidence(C$ 9.6 million) but a net cost of C$ 265 million for the Beaver Dam model. Conclusions:AREDS antioxidant supplementation appears to be a dominant strategy for treating macular degeneration. Applied to the whole Canadian population, the potential medical cost savings for Visudyne treatment of neovascular AMD are C$5.6 billion dollars direct costs. These values would be tenfold higher for the USA, because of the currency and population size differences.

Keywords: antioxidants • retina • age–related macular degeneration 
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