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Jeffrey Yu, Jason Matthew Lewis Miller, Mark Johnson, Benjamin Young; Cost analysis and adherence of over the counter supplements to the AREDS2 protocol. Invest. Ophthalmol. Vis. Sci. 2022;63(7):358 – F0189.
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To examine "AREDS- and AREDS2-based" supplements available for purchase online, with attention to their cost and adherence to the formulation tested in the AREDS2 protocol.
“AREDS” and “AREDS2” were used as search terms in Amazon and Google Shopping. The top 30 search results, excluding items marked as promoted ads, were recorded for each search, and each product was checked for compliance with the AREDS2 formula, allowing for both low (25mg) and high (80mg) zinc formulations. The price per daily serving was calculated for each product and prices of “compliant” vs. “non-compliant” formulas were compared using Student’s t-tests.
120 search results were analyzed across Amazon and Google Shopping. 30.8% (37/120) of the products did not adhere to the AREDS2 formula. 14.2% (17/120) were missing at least one of the ingredients in the AREDS2 formula. 5.8% (7/120) followed the AREDS1 formula. 17.5% (21/120) contained a higher dose of at least one ingredient and 13.3% (16/120) contained less of at least one ingredient than in the AREDS2 formula. 15.8% (19/120) contained at least one extra ingredient beyond those in the AREDS2 formula. The products that deviated in any way from the AREDS2 formulation were 26.0 percent more expensive than those that did not ($0.63 vs. $0.50 per day, p = 0.0027). Similarly, products that were missing at least one of the ingredients in the AREDS2 formula were 26.9 percent more expensive than those that were not ($0.66 vs. $0.52, p = 0.012).
Our analysis demonstrates that many of the AREDS2 supplements found using popular online shopping marketplaces deviate from the formulations recommended by the AREDS2 clinical trials. Several of the formulations had decreased or missing dosages of vitamin C and vitamin E. Further, some included extra ingredients that have not been shown to be beneficial in AMD but were advertised as such, including bilberry extract, fish oil, and alpha-lipoic acid. Moreover, several of the supplements followed the AREDS1 formula, which is no longer recommended as it imposes increased risk of lung cancer for smokers. Importantly, we also found that products that did not follow the AREDS2 formula were more expensive on average to the consumer. Clinicians may wish to be specific in their recommendation of AREDS2 formulations to avoid inaccurate dosing.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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