Treatment costs of cystoid macular edema among patients following cataract surgery

Jordana K Schmier,1 David W Covert,2 Carolyn K Hulme-Lowe,1 Anmol Mullins,3 Emmanuel M Mahlis4 1Health Sciences, Exponent Inc., Alexandria, VA, 2Health Economics, 3Global Market Access, 4US Pharma Medical Affairs, Alcon Inc., Fort Worth, TX, USA Purpose: The current costs of treating cystoid macul...

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Autores principales:	Schmier JK, Covert DW, Hulme-Lowe CK, Mullins A, Mahlis EM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Claims analysis Costs and cost analysis Cystoid macular edema Diabetic retinopathy Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6f2086ec5bb9480f94b99b8612b7a5f3
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spelling	oai:doaj.org-article:6f2086ec5bb9480f94b99b8612b7a5f32021-12-02T03:38:28ZTreatment costs of cystoid macular edema among patients following cataract surgery1177-5483https://doaj.org/article/6f2086ec5bb9480f94b99b8612b7a5f32016-03-01T00:00:00Zhttps://www.dovepress.com/treatment-costs-of-cystoid-macular-edema-among-patients-following-cata-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jordana K Schmier,1 David W Covert,2 Carolyn K Hulme-Lowe,1 Anmol Mullins,3 Emmanuel M Mahlis4 1Health Sciences, Exponent Inc., Alexandria, VA, 2Health Economics, 3Global Market Access, 4US Pharma Medical Affairs, Alcon Inc., Fort Worth, TX, USA Purpose: The current costs of treating cystoid macular edema (CME), a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. Setting: Nationally representative database. Design: Retrospective analysis of the 2011 through 2013 Medicare 5% Beneficiary Encrypted Files. Methods: Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases) or no diagnosis of CME (controls) within 6 months following surgery. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored the rates of CME in beneficiaries based on the presence of selected comorbidities and by the type of procedure (standard vs complex). Total Medicare and ophthalmic costs for cases and controls are presented. The analysis explored the effect of considering diabetic macular edema (DME) and macular edema (ME) as exclusion criteria. Results: Of 78,949 beneficiaries with cataract surgery, 2.54% (n=2,003) were diagnosed with CME. One-third of beneficiaries had one or more conditions affecting retinal health (including diabetes), 4.5% of whom developed CME. The rate of CME, at 22.5%, was much higher for those patients with preoperative DME or ME. Ophthalmic charges were almost twice as high for cases compared with controls (US$10,410 vs $5,950); payments averaged 85% higher ($2,720 vs $1,470) (both P<0.0001). Conclusion: Substantial costs can be associated with CME; beneficiaries whose retinas are already compromised before cataract surgery face higher risk. Cost savings could be realized with the use of therapies that reduce the risk of developing CME. Future analyses could identify whether and to what extent comorbidities influence costs. Keywords: claims analysis, costs and cost analysis, cystoid macular edema, diabetic retinopathySchmier JKCovert DWHulme-Lowe CKMullins AMahlis EMDove Medical PressarticleClaims analysisCosts and cost analysisCystoid macular edemaDiabetic retinopathyOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 477-483 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Claims analysis Costs and cost analysis Cystoid macular edema Diabetic retinopathy Ophthalmology RE1-994
spellingShingle	Claims analysis Costs and cost analysis Cystoid macular edema Diabetic retinopathy Ophthalmology RE1-994 Schmier JK Covert DW Hulme-Lowe CK Mullins A Mahlis EM Treatment costs of cystoid macular edema among patients following cataract surgery
description	Jordana K Schmier,1 David W Covert,2 Carolyn K Hulme-Lowe,1 Anmol Mullins,3 Emmanuel M Mahlis4 1Health Sciences, Exponent Inc., Alexandria, VA, 2Health Economics, 3Global Market Access, 4US Pharma Medical Affairs, Alcon Inc., Fort Worth, TX, USA Purpose: The current costs of treating cystoid macular edema (CME), a complication that can follow cataract surgery, are largely unknown. This analysis estimates the treatment costs for CME based on the recently released US Medicare data. Setting: Nationally representative database. Design: Retrospective analysis of the 2011 through 2013 Medicare 5% Beneficiary Encrypted Files. Methods: Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases) or no diagnosis of CME (controls) within 6 months following surgery. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored the rates of CME in beneficiaries based on the presence of selected comorbidities and by the type of procedure (standard vs complex). Total Medicare and ophthalmic costs for cases and controls are presented. The analysis explored the effect of considering diabetic macular edema (DME) and macular edema (ME) as exclusion criteria. Results: Of 78,949 beneficiaries with cataract surgery, 2.54% (n=2,003) were diagnosed with CME. One-third of beneficiaries had one or more conditions affecting retinal health (including diabetes), 4.5% of whom developed CME. The rate of CME, at 22.5%, was much higher for those patients with preoperative DME or ME. Ophthalmic charges were almost twice as high for cases compared with controls (US$10,410 vs $5,950); payments averaged 85% higher ($2,720 vs $1,470) (both P<0.0001). Conclusion: Substantial costs can be associated with CME; beneficiaries whose retinas are already compromised before cataract surgery face higher risk. Cost savings could be realized with the use of therapies that reduce the risk of developing CME. Future analyses could identify whether and to what extent comorbidities influence costs. Keywords: claims analysis, costs and cost analysis, cystoid macular edema, diabetic retinopathy
format	article
author	Schmier JK Covert DW Hulme-Lowe CK Mullins A Mahlis EM
author_facet	Schmier JK Covert DW Hulme-Lowe CK Mullins A Mahlis EM
author_sort	Schmier JK
title	Treatment costs of cystoid macular edema among patients following cataract surgery
title_short	Treatment costs of cystoid macular edema among patients following cataract surgery
title_full	Treatment costs of cystoid macular edema among patients following cataract surgery
title_fullStr	Treatment costs of cystoid macular edema among patients following cataract surgery
title_full_unstemmed	Treatment costs of cystoid macular edema among patients following cataract surgery
title_sort	treatment costs of cystoid macular edema among patients following cataract surgery
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/6f2086ec5bb9480f94b99b8612b7a5f3
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_version_	1718401669900795904

Treatment costs of cystoid macular edema among patients following cataract surgery

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