Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Economic Burden of Uveitis.

E. Kirbach,  S., A. Hayes,  O., A. Cifaldi,  M.

Background and Purpose:

Uveitis is a common extra-articular manifestation of rheumatic conditions (including ankylosing spondylitis and juvenile idiopathic arthritis). It often recurs and is associated with potentially serious sequelae that greatly increase the risk of vision loss.1 Uveitis is responsible for >=10% of blindness in the United States and is associated with a total direct cost of approximately $2.74 billion.2,3 Despite this financial burden, there is a dearth of literature examining the economic burden specific to uveitis, especially with regard to the impact of uncontrolled disease and the presence of blindness and vision loss. We determined the average annual medical costs for individuals newly diagnosed with noninfectious uveitis based on location of inflammation, presence of blindness, and number of subsequent uveitis-related medical visits.

Methods:

Patients (N=26,079) with noninfectious uveitis (based on ICD-9 codes) and >=2 years of continuous enrollment (>=1 year before and after diagnosis of first episode) were identified in the MedStat MarketScan database (2000–2008) and categorized by uveitis type (anterior vs. intermediate/posterior/panuveitis [IPP]), incident and prevalent blindness, and number of uveitis-related medical visits (1, 2, 3, or >3 visits). Average annual medical costs were calculated for the year following the initial diagnosis of uveitis. Patients with health maintenance organization, point of service with capitation, or missing insurance plans were excluded from cost summations.

Results:

The average annual cost for all individuals with noninfectious uveitis was $8,450 vs. $4,688 for nonuveitis controls. For all patients with uveitis, those with IPP uveitis incurred greater costs than those with anterior uveitis ($12,149 vs. $7,834, respectively). Patients who became blind during the observation period had greater costs than those who maintained their sight ($21,384 vs. $8,236, respectively) and those who were blind at the start of the follow-up period ($14,404). The largest driver of medical costs for patients with noninfectious uveitis was outpatient hospitalizations (29% of all costs) followed by drug costs (22% of all costs). In terms of uveitis-related medical visits, medical costs uniformly increased with number of visits (table).

Annual Medical Costs for Noninfectious Uveitis Patients by Type, Presence of Blindness, and Number of Uveitis-Related Medical Visits

 All ($)1 Visit ($)2 Visits ($)3 Visits ($)>3 Visits ($)
Noninfectious Uveitis
  All (N = 34,632)8,4507,9088,72310,01612,513
  Blind (N = 770)17,84616,56715,15218,97225,882
  Nonblind (N = 33,862)8,2367,7428,5549,72911,859
IPP Uveitis
  All (N = 4,708)12,14910,90011,52315,11723,976
  Blind (N = 229)23,61916,75819,88030,68650,207
  Nonblind (N = 4,479)11,60710,68410,99413,90721,185
Anterior Uveitis
  All (N = 29,924)7,8347,4128,2659,11710,523
  Blind (N = 541)15,50316,49812,86412,72515,213

Conclusions:

Uveitis results in a large degree of economic burden, especially for individuals with more severe disease or blindness and for those with repeated uveitis-related medical visits.

References:

1Durrani, O, et al. Ophthalmologica. 2004 218 223–36.

2Rothova, A, et al. Br J Ophthalmol. 1996 80 332–6.

3Prevent Blindness America 2007. Available at:www.preventblindness.org. Accessed October 30, 2009.

To cite this abstract, please use the following information:
E. Kirbach, S., A. Hayes, O., A. Cifaldi, M.; The Economic Burden of Uveitis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :788
DOI: 10.1002/art.28556

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