The Burden of Macular Diseases in Central and Eastern Europe—Implications for Healthcare Systems

• Published in: Value in health regional issues Vol. 19; pp. 1 - 6
• Main Authors: Jaki Mekjavić, Polona, Jūratė Balčiūnienė, Vilma, Ćeklić, Lala, Ernest, Jan, Jamrichova, Zuzana, Zsolt Nagy, Zoltán, Petkova, Iva, Teper, Sławomir, Gardašević Topčić, Ivana, Veith, Miroslav
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2019
• Subjects: age-related macular degeneration; anti-VEGF; Cost of Illness; Delivery of Health Care - economics; diabetic retinopathy; Europe - epidemiology; Guidelines as Topic - standards; health policy; Health Policy - economics; Humans; indirect costs; macular edema; Macular Edema - epidemiology; Reimbursement Mechanisms; retinal diseases; Retinal Diseases - therapy; Wet Macular Degeneration - epidemiology; Europe; indirect costs; retinal diseases; health policy; anti-VEGF; macular edema; diabetic retinopathy; age-related macular degeneration
• ISSN: 2212-1099; 2212-1102
• DOI: 10.1016/j.vhri.2018.11.002

Despite the significant impact of retinal diseases such as wet age-related macular degeneration (wAMD) and diabetic macular edema (DME), there is a limited understanding of how these conditions are managed in Central and Eastern Europe (CEE).
To provide a comprehensive overview of the clinical and economic burden of wAMD and DME in CEE and the status quo associated with their management.
A narrative literature review was undertaken to identify existing data on wAMD and DME, including epidemiology, economic burden, clinical guidelines, and available and reimbursed treatments. Data were collected from relevant sources such as PubMed, ophthalmology associations, national statistical offices, and government agency websites; practical viewpoints were provided by local ophthalmologists and healthcare economics experts in CEE.
Epidemiological data on wAMD and DME are limited in CEE, and intercountry comparison is difficult because of differences in data collection methodologies. There are effective treatment options for wAMD and DME, and international guidelines advocate the use of intravitreal anti-vascular endothelial growth factor injections as first-line therapy. Local expert organizations broadly support these recommendations; nevertheless, no clinical practice guidelines exist on the treatment of wAMD and DME in CEE. Access to and reimbursement of anti-vascular endothelial growth factor agents vary significantly in the region and, as a result, many patients remain untreated or inadequately treated.
There is an urgent need for the creation of a wAMD/DME treatment program in CEE to ensure that patients have timely access to the most appropriate treatments.
•The prevalence of wet age-related macular degeneration (wAMD) and diabetic macular edema (DME) is increasing because of aging populations and the increase in the number of diabetes cases. These diseases pose a significant global economic and clinical burden, potentially leading to vision loss and having a negative impact on patients' quality of life. Although effective pharmacological treatments are widely available, access to these agents in the Central and Eastern European (CEE) region is not aligned with other regions.•AMD alone is responsible for 19.5% and 15.9% of all blindness cases reported in Eastern Europe and Central Europe, respectively. Despite the high impact of retinal diseases such as wAMD and DME, there is a limited understanding of how healthcare systems in the CEE countries are managing these patients. This review provides a comprehensive overview of the status quo associated with wAMD and DME management in the CEE region, their clinical and economic burden, and how the CEE region compares with other countries in terms of approval and reimbursement policies. The authors also provide a critical assessment of access barriers and the limitations associated with wAMD and DME management in the CEE region.•This article provides the first comprehensive review of the clinical and economic impact of wAMD and DME in the CEE region. A group of experts provides a critical appraisal of how the diseases have an impact on the CEE countries and how healthcare systems are currently managing wAMD and DME. The authors identify gaps and limitations in the current approach, but also provide examples of how other healthcare systems and clinical organizations have successfully addressed the management of wAMD and DME.