Macular Edema Adds to Cost Burden for Elderly Diabetics

New onset of the disease adds almost one-third to medical costs

22 dec 2008-- New-onset diabetic macular edema in elderly patients increases medical costs by almost one-third, according to a report published in the December issue of the Archives of Ophthalmology.

Alisa M. Shea, of Duke University in Durham, N.C., and colleagues analyzed 2000 through 2004 data on Medicare beneficiaries, using a nationally representative 5 percent sample to determine the incidence of diabetic macular edema, and compared health care costs of patients with diabetic macular edema with a control cohort of patients with diabetes mellitus but no retinal disease history.

The impact of new-onset diabetic macular edema was significant; after controlling for confounding factors it added 31 percent to one-year medical costs and 29 percent to three-year medical costs, the researchers report. The use of tests and treatment also changed across the period under study, with 13 percent of patients receiving intravitreal injections in 2004 versus 1 percent in 2000, while optical coherence tomography use rose from 2.5 percent of patients in 2000 to over 40 percent in 2004, the report indicates.

"It has been estimated that approximately one-third of cases of diabetes mellitus in adults aged 20 years and older is undiagnosed," the authors write. "To the extent that this is true in the Medicare population, our findings may underestimate total costs associated with the disease."

Several study authors report financial relationships with the pharmaceutical industry.

Abstract