Costs of Newly Diagnosed Neovascular Age-Related Macular Degeneration Among Medicare Beneficiaries, 2004-2008

Retina. 2013 Apr;33(4):854-61. doi: 10.1097/IAE.0b013e31826f065e.


Purpose: To examine associations between newly diagnosed neovascular age-related macular degeneration and direct medical costs.

Methods: This retrospective observational study matched 23,133 Medicare beneficiaries diagnosed with neovascular age-related macular degeneration between 2004 and 2008 with a control group of 92,532 beneficiaries on the basis of age, sex, and race. The index date for each case-control set corresponded to the first diagnosis for the case. Main outcome measures were total costs per patient and age-related macular degeneration-related costs per case 1 year before and after the index date.

Results: Mean cost per case in the year after diagnosis was $12,422, $4,884 higher than the year before diagnosis. Postindex costs were 41% higher for cases than controls after adjustment for preindex costs and comorbid conditions. Age-related macular degeneration-related costs represented 27% of total costs among cases in the postindex period and were 50% higher for patients diagnosed in 2008 than in 2004. This increase was attributable primarily to the introduction of intravitreous injections of vascular endothelial growth factor antagonists. Intravitreous injections averaged $203 for patients diagnosed in 2004 and $2,749 for patients diagnosed in 2008.

Conclusion: Newly diagnosed neovascular age-related macular degeneration was associated with a substantial increase in total medical costs. Costs increased over time, reflecting growing use of anti-vascular endothelial growth factor therapies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / economics
  • Databases, Factual
  • Direct Service Costs / statistics & numerical data*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Services Research
  • Humans
  • Male
  • Medicare Part B / economics*
  • Retrospective Studies
  • United States
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Wet Macular Degeneration / diagnosis
  • Wet Macular Degeneration / drug therapy
  • Wet Macular Degeneration / economics*


  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A