Annual prevalence of geographic atrophy and wet age-related macular degeneration among Medicare Advantage enrollees in a US health plan.

IF 2.3 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of managed care & specialty pharmacy Pub Date : 2025-01-01 DOI:10.18553/jmcp.2025.31.1.88

Vishal Saundankar, Mark Borns, Kelly Broderick, Birva Shah, Stuart Cowburn, Steven McFadden, Brandon Suehs

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引用次数: 0

Abstract

Background: Geographic atrophy (GA) is an advanced form of dry age-related macular degeneration (AMD) that can lead to visual impairment. Published studies estimate approximately 1 million people in the United States have GA in at least 1 eye. There is a lack of real-world evidence from the US payer perspective on the prevalence of AMD and GA among Medicare Advantage prescription drug (MAPD) plan enrollees.

Objective: To estimate the annual prevalence of GA, wet AMD, and co-occurring GA and wet AMD among MAPD plan enrollees from 2018 through 2021.

Methods: This retrospective, cross-sectional study estimated the prevalence of GA and AMD based on Medicare Advantage enrollee claims data. Individuals aged 65 years and older who had continuous enrollment throughout each calendar year constituted the denominator for each annual prevalence calculation. Enrollees with at least 1 medical claim with a diagnosis code for GA or wet AMD during each year were identified to estimate annual prevalence for that respective calendar year.

Results: The total number of patients in the denominator was 2,175,803 (2018); 2,445,163 (2019); 2,680,322 (2020); and 2,905,366 (2021). The annual prevalence of GA was 0.56% (2018), 0.55% (2019), 0.48% (2020), and 0.51% (2021). The annual prevalence of wet AMD was 1.2% (2018), 1.3% (2019), 1.2% (2020), and 1.3% (2021). The prevalence of GA was highest among individuals classified as White race (annual range 0.61% to 0.71%) and among patients with GA aged 75 years and older (range 0.95% to 1.11%). The proportion of patients with GA with co-occurring wet AMD was 25.6% to 28.0%. The annual prevalence of advanced AMD (GA or wet AMD) was 1.6% to 1.7%.

Conclusions: In the Medicare populations, the prevalence of GA was greatest among patients aged 75 years and older and individuals classified as White race. A substantial proportion of individuals with GA had evidence of co-occurring wet AMD. MAPD plans should evaluate how their membership may be impacted by the recently approved medications for the treatment of GA.

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地理萎缩和湿性年龄相关性黄斑变性在美国医疗保险优势参保者中的年度患病率。

背景：地理萎缩（GA）是干性年龄相关性黄斑变性（AMD）的一种晚期形式，可导致视力损害。已发表的研究估计，在美国大约有100万人至少有一只眼睛患有GA。从美国付款人的角度来看，在医疗保险优势处方药（MAPD）计划的参保人中，AMD和GA的患病率缺乏真实的证据。目的：估计2018年至2021年MAPD计划参保者GA、湿性AMD以及GA和湿性AMD共发的年患病率。方法：这项回顾性的横断面研究估计了GA和AMD的患病率，基于医疗保险优势参保者的索赔数据。在每个日历年连续入组的65岁及以上个体构成每个年度患病率计算的分母。每年至少有1个医疗索赔的GA或湿性AMD诊断代码的参与者被确定，以估计相应日历年的年患病率。结果：分母患者总数为2175803例（2018年）；2445163 (2019);2680322 (2020);和2,905,366（2021）。GA年患病率分别为0.56%（2018年）、0.55%（2019年）、0.48%（2020年）和0.51%（2021年）。湿性AMD的年患病率分别为1.2%（2018年）、1.3%（2019年）、1.2%（2020年）和1.3%（2021年）。白种人和75岁及以上的GA患者的GA患病率最高（分别为0.61% ~ 0.71%和0.95% ~ 1.11%）。GA合并湿性AMD的患者比例为25.6% ~ 28.0%。晚期AMD （GA或湿性AMD）的年患病率为1.6% ~ 1.7%。结论：在医疗保险人群中，GA的患病率在75岁及以上的患者和被归类为白人的个体中最高。相当大比例的GA患者有共同发生湿性AMD的证据。MAPD计划应评估其成员资格如何受到最近批准的GA治疗药物的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of managed care & specialty pharmacy Health Professions-Pharmacy

CiteScore

3.50

自引率

4.80%

发文量

131

期刊介绍： JMCP welcomes research studies conducted outside of the United States that are relevant to our readership. Our audience is primarily concerned with designing policies of formulary coverage, health benefit design, and pharmaceutical programs that are based on evidence from large populations of people. Studies of pharmacist interventions conducted outside the United States that have already been extensively studied within the United States and studies of small sample sizes in non-managed care environments outside of the United States (e.g., hospitals or community pharmacies) are generally of low interest to our readership. However, studies of health outcomes and costs assessed in large populations that provide evidence for formulary coverage, health benefit design, and pharmaceutical programs are of high interest to JMCP’s readership.