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Updated: May 30, 2026
Characterization of Vascular Morphology of Neovascular Age-Related Macular Degeneration by Indocyanine Green Angiography
Published on: August 11, 2023
Medicare costs for neovascular age-related macular degeneration, 1994-2007
Shelley Day1, Kofi Acquah, Paul P Lee
1Department of Ophthalmology, Duke Eye Center, Durham, North Carolina, USA.
Purpose:
To assess changes in Medicare payments for neovascular age-related macular degeneration (AMD) since introduction of anti-vascular endothelial growth factor (VEGF) therapies.
Design:
Retrospective, longitudinal cohort study.
Methods:
Using the Medicare 5% sample, beneficiaries with new diagnoses of neovascular AMD in 1994 (N = 2497), 2000 (N = 3927), and 2006 (N = 6041) were identified using International Classification of Diseases (ICD-9-CM). The total first-year health care and eye care costs were calculated for each beneficiary. Propensity score matching was used to match individuals in the 2000 and 2006 cohorts with the 1994 cohort on age, sex, race, Charlson Comorbidity Index, and low vision/blindness.
Results:
The number of beneficiaries newly diagnosed with neovascular AMD more than doubled between the 1994 and 2006 cohorts. Overall yearly Part B payments per beneficiary increased significantly from $3567 for the 1994 to $5991 for the 2006 cohort (P < .01) in constant 2008 dollars. Payments for eye care alone doubled from $1504 for the 1994 cohort to $3263 for the 2006 cohort (P < .01). Most of the increase in payments for eye care in 2006 reflected payments for anti-VEGF injections, which were $1609 over 1 year. Mean annual numbers of visits and imaging studies also increased significantly between the 1994 and 2006 cohort. Results were similar in the matched sample.
Conclusions:
The introduction of anti-VEGF intravitreal injections has offered remarkable clinical benefits for patients with neovascular AMD, but these benefits have come at the cost of an increased financial burden of providing care for these patients.
Insights
Medicare payments for neovascular age-related macular degeneration (AMD) care significantly increased after anti-vascular endothelial growth factor (VEGF) therapies were introduced. While these treatments offer clinical benefits, they also represent a substantial rise in healthcare costs for patients with AMD.
Area of Science:
- Ophthalmology
- Health Economics
- Public Health
Background:
- Neovascular age-related macular degeneration (AMD) is a leading cause of vision loss in older adults.
- Anti-vascular endothelial growth factor (VEGF) therapies have revolutionized neovascular AMD treatment.
- Understanding the economic impact of these therapies on Medicare is crucial.
Purpose of the Study:
- To evaluate changes in Medicare payments for neovascular AMD care.
- To assess the financial implications following the introduction of anti-VEGF therapies.
Main Methods:
- Retrospective, longitudinal cohort study using the Medicare 5% sample.
- Identified beneficiaries newly diagnosed with neovascular AMD in 1994, 2000, and 2006.
- Calculated first-year healthcare and eye care costs, using propensity score matching for cohort comparison.
Main Results:
- The number of new neovascular AMD diagnoses more than doubled from 1994 to 2006.
- Annual Medicare Part B payments per beneficiary increased significantly, from $3567 (1994) to $5991 (2006) in 2008 dollars.
- Eye care payments doubled, with anti-VEGF injections accounting for $1609 in 2006; patient visits and imaging also increased.
Conclusions:
- Anti-VEGF intravitreal injections provide significant clinical benefits for neovascular AMD patients.
- These therapeutic advancements have led to a considerable increase in the financial burden of care for neovascular AMD.
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