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Clinton Ellingson, Jayakrishna Ambati; Appropriate use of AREDS vitamins in the ophthalmic population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):17.
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Age-related Macular Degeneration (AMD) is the leading cause of blindness in the developing world and can be sub-classified as exudative and non-exudative. In 2007 a vitamin formulary was studied and recommended for specific classifications of non-exudative AMD by the Age-Related Eye Disease Study (AREDS). The purpose of this study is to assess the appropriate use of eye vitamins based on AREDS recommendations and estimate the associated cost utility.
This is a random, prospective, cross-sectional clinic-based study. Patients presenting to the ophthalmology clinic at an academic medical center who had a diagnosis of AMD or were actively taking eye vitamins were enrolled. Fundus examination was performed, and the participant’s stage of AMD based on AREDS criteria and best-corrected visual acuity were recorded. A questionnaire inquiring about eye vitamin use, brand preference, estimated quarterly costs, length of use, family history, awareness of adverse effects, and reasons for starting vitamins, was administered.
134 patients met the inclusion criteria and elected to participate in the study. Of the 101 participants taking eye vitamins, 73.5% did not meet AREDS criteria. 29.6% of the respondents reported taking a vitamin preparation identical to the AREDS formulation. The number needed to treat (NNT) was adjusted to account for participants taking eye vitamins that did not meet AREDS criteria or were taking a formulary different than the one recommended and was determined to be 220. Participants reported an average estimated quarterly cost of $39.65-$59.75. Depending on the initial visual acuity, the direct cost utility from inappropriate vitamin use ranged between $218,000-$657,000 per quality adjusted life year. 86% of participants who were active smokers were unaware that certain eye vitamins may place them at an increased risk for lung cancer.
An overwhelming proportion of eye vitamin users did not meet AREDS treatment criteria or used an unproven vitamin formula, thereby effectively increasing the NNT, which increases costs per benefit, reduces therapy effectiveness, and increases exposure to unnecessary adverse drug effects.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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