Dr Paul Hahn on the Importance of Understanding the Economic Value of DME Treatments

For vision-threatening diseases, understanding the economic value of treatments can help identify the direct and indirect benefits of different treatments, said Paul Hahn, MD, vitreoretinal surgeon at NJRetina.

Transcript

Which therapies are you looking at to better understand the economic value of treatments for diabetic macular edema (DME)?

Treatment of DME can involve observation, and it can involve interventions such as, most commonly, intravitreal anti-VEGF [vascular endothelial growth factor] therapy; steroids, such as intravitreal or periocular steroids; or focal laser treatment. In this project, we looked at the impact of all treatments combined to learn the economic impact of treatment of DME. But of course, the biggest impact is contributed by anti-VEGF therapy, which is the most commonly performed treatment for this condition.

With the population aging and the prevalence of diabetes increasing, what is the importance of understanding the economic value of treatments for diabetic macular edema?

As a retina specialist, we all understand very well how important it is to save someone's vision. And for the patient who's losing vision, they all understand that very well, also. But for most of us who don't have vision problems, we take our vision for granted, and that includes people who make decisions as to where resources are being allocated. It's important to understand the economic value of treatment of diabetic macular edema and other vision-threatening diseases to be able to place that in context and objectively understand how much value is created.

So, in this project, we looked at both the value of treatment of DME at an individual level and scaled that up to a national level. At an individual level, for example, we find increases in direct benefits and indirect benefit. Direct benefits meaning things like life expectancy, quality of life, and indirect benefits being disability, employment, and so forth. We find benefits for both. In fact, if we look at a hypothetical 51-year-old in our model, we find that the value of treatment of DME in that typical 51-year-old is equivalent to modelled value seen in other published reports of elimination of chronic disease or of immunotherapy for non–small cell lung cancer, a revolutionary treatment. It really highlights the importance of treatment of DME at an individual level.

If we scale that up to society, and if we look at the US population of DME, we see about $5.5 billion of direct and indirect benefits over 2 years, and that increases to almost $70 billion over 20 years. Again, just highlighting the importance of treatment of these vision-threatening diseases. In this era where health care resources are increasingly limited, I think understanding the economic value of treatment of diabetic macular edema is important to place that in context and really support the value for this.