Epidemiology, treatment pattern and health care utilization of myopic choroidal neovascularization: a population based study

Purpose To investigate the prevalence and incidence of myopic choroidal neovascularization (CNV) in Taiwan, including the health care utilization and treatment-associated costs. Methods A retrospective cohort study using existing data from the Taiwanese National Health Insurance claims database to i...

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Published in:	Japanese journal of ophthalmology Vol. 61; no. 2; pp. 159 - 168
Main Authors:	Yang, Ming-Chin, Chen, Yen-Po, Tan, Elise Chia-Hui, Leteneux, Claudia, Chang, Erin, Chu, Carol HY, Lai, Chi-Chun
Format:	Journal Article
Language:	English
Published:	Tokyo Springer Japan 01-03-2017 Springer Nature B.V
Subjects:	Choroidal Neovascularization - epidemiology Choroidal Neovascularization - etiology Choroidal Neovascularization - therapy Clinical Investigation Female Fluorescein Angiography Follow-Up Studies Fundus Oculi Humans Incidence Male Medicine Medicine & Public Health Middle Aged Myopia, Degenerative - complications Myopia, Degenerative - epidemiology Myopia, Degenerative - therapy Ophthalmology Patient Acceptance of Health Care Population Surveillance - methods Retrospective Studies Taiwan - epidemiology Neovascularization Epidemiology Ranibizumab Myopia Taiwan
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Summary:	Purpose To investigate the prevalence and incidence of myopic choroidal neovascularization (CNV) in Taiwan, including the health care utilization and treatment-associated costs. Methods A retrospective cohort study using existing data from the Taiwanese National Health Insurance claims database to identify patients who had a diagnosis of myopic CNV recorded from 1 January 2009 to 31 December 2011. The prevalence of myopic CNV was monitored during this period, and the frequency and cost of both treatment visits and monitoring visits were analyzed for 2 years following diagnosis. Results The prevalence of myopic CNV was 0.017%. In total, 9068 patients with myopic CNV were identified, 12.3% ( n = 1111) of whom were treated. Of those treated, 72.0% ( n = 800) received intravitreal anti-vascular endothelial growth factor injections (IVI); the remainder received either photodynamic therapy with verteporfin (vPDT), laser photocoagulation, or a combination of therapies. IVI was associated with the largest number of treatment visits as well as a higher administrative (non-drug) cost per treatment visit (a mean of USD 57.18). vPDT alone was associated with a higher overall cost per treatment visit and more monitoring visits than IVI or laser photocoagulation. Costs for monitoring visits were highest for IVI. Conclusions The prevalence of myopic CNV was lower than that reported in previous studies, possibly because of differences in age distribution in the populations studied. The frequencies of treatment administered were similar to those reported in previous studies; however, a cost-effectiveness comparison could not be made owing to lack of data in previous studies.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0021-5155 1613-2246
DOI:	10.1007/s10384-016-0496-3