The AMD Alliance International (AMDAI) today issued a global call to action to the vision care community, to ensure appropriate access to care for patients living with wet age-related macular degeneration (AMD), a condition where new blood vessels grow into the back of the eye, seriously damaging vision, and to support ongoing research for improved treatment options. The global call to action stems from a pending report that underscores the need to recognize wet AMD as a chronic disease, and the significant emotional, physical and economic burden associated with treating the disease as an acute condition. A webcast discussing details to the report will be taking place today at 10am EST/3pm BST/4pm CEST, and can be accessed here.
Chronic disease is defined as persistent, lasting, generally incurable, and requiring ongoing treatment; yet in some countries, wet AMD is treated and reimbursed as an acute disease-decreasing access, limiting patient outcomes, and potentially endangering sight.
Age-related macular degeneration is a leading cause of blindness in the developed world, and is twice as prevalent as Alzheimer’s disease, affecting approximately 30 million people worldwide. Some health care systems, including in developed countries, focus on informal care for patients with episodes of acute illness, a model that is not cost-effective for treating wet AMD and other chronic diseases. In fact, data on asthma and congestive heart failure indicate that cost savings and quality improvements result from long-term management of the chronic diseases outside the hospital, by preventing acute episodes from occurring.[1] Globally, the cost of visual impairment due to AMD in 2010 is estimated at $343 billion.[2] This is due not only to the direct costs of treating the disease, but also with the associated dangers that come with diminished eyesight. Further, people suffering from AMD were deprived of the equivalent of an estimated six million years of healthy life due to disability and premature death.
“For those of us involved in and concerned about vision care, this report highlights the need to continue advocating for patient access to the ongoing care that is required to prevent vision loss from wet AMD,” said Narinder Sharma, Chief Executive Officer of AMDAI. “The burden that this disease places on patients, caregivers, health care systems, and society at large can currently be relieved only through timely diagnosis, earlier intervention, and sustained therapy-all core practices for managing chronic conditions-until there are newer, better treatments, and hopefully one day a cure.”
The report incorporates input from an expert panel of patient and policy advocates, as well as patient focus groups across Europe and the United States. Based on the findings, AMDAI will lead its more than 70 patient groups around the world to advocate for those living with wet AMD, call for access to appropriate care and approved, safe therapies to help AMD patients maintain sight as long as possible and live full, productive lives through:
– Early diagnosis and access to regular treatment: Early detection is key to saving vision. Wet AMD progresses rapidly, but progression can be slowed with unimpeded access to appropriate treatment.
– Increased patient and physician awareness: Public awareness about wet AMD must be enhanced, so that signs and symptoms are more easily recognized, particularly among populations at risk.
– New and better treatments for wet AMD: Drugs in development must have proven clinical safety and long-term efficacy, be made available to all who live with wet AMD, and ultimately arrest disease progression and restore sight.
– An integrated model of care that includes prevention, diagnosis, treatment, and rehabilitation: Health care teams should educate themselves and their patients about wet AMD to intervene and preserve vision to the fullest extent, as well as provide resources for support and rehabilitation.
The report asserts that treating wet AMD as a chronic disease will help ensure that affected patients get the early medical attention and treatment they need to live longer, healthier, more independent lives, thereby reducing the need for high-cost medical care and social services. The report covers the global challenge of AMD; current and developing treatments; necessary intervention, treatment, rehabilitation and emotional support; improving physicians’ ability to educate and care for wet AMD patients; and empowering patients to advocate on their own behalf.
There is no cure for wet AMD, but there are several approved therapies on the market for the treatment of wet AMD. Wet AMD approved treatments include laser surgery, photodynamic therapy, and, most recently, anti-VEGF therapy that is administered by a drug injection into the eye. This latter treatment can arrest and, in some cases, reverse vision loss.
While anti-VEGF therapy represents a significant advancement in the treatment of wet AMD, there is still no cure. Eye care specialists and global leaders point to significant remaining unmet needs:[3] improved drug delivery methods, improved efficacy for drugs that are injected into the eye, reduced frequency of treatment and dosing, combined therapies that can improve efficacy and the burden of treatment on physicians and patients, drugs that reverse the disease process, and most importantly, a standardized, integrated treatment paradigm that accounts for chronic management of wet AMD.
About AMD
Age-related macular degeneration is a leading cause of blindness in the developed world, and is twice as prevalent as Alzheimer’s disease, affecting approximately 30 million people worldwide. AMD progressively and gradually diminishes the central vision necessary to see objects clearly and to perform common tasks, such as reading and driving. In some cases, AMD advances so slowly that people notice little change in their vision; in others, progression may rapidly lead to loss of vision in both eyes. Although AMD may occur during middle age, people over age 60 are at greater risk than younger people.
AMD occurs in two forms: dry and wet. Dry AMD is an early stage of the disease that occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. It may result from aging and thinning of the macular tissues. Over time, as less of the macula functions, central vision is gradually lost in the affected eye. The dry AMD patent will likely have blurred vision, have difficulty recognizing faces, and need more light for reading and other activities. Dry AMD generally affects both eyes, but vision can be lost in only one eye while the other eye seems unaffected.[4]
In 10 to 15 percent of cases, dry AMD advances to wet AMD. Wet AMD is the leading cause of blindness in people over the age of 65 in the U.S. and Europe. In wet AMD, abnormal blood vessels develop behind the macula and leak blood and fluid that lead to visual impairment. Wet AMD can lead to sight loss in as little as three months.
[1] Thrall, James H., MD, , Prevalence and Costs of Chronic Disease in a Health Care System Structured for Treatment of Acute Illness, Radiology, 2005
[2] The Global Economic Cost of Visual Impairment, Access Economics, prepared for AMD Alliance International, March 2010 (costs reported in 2008 US dollars).
[3] DataMonitor: Ophthalmology: Stakeholders Opinions – Leading Brands Under Threat, March 2010
[4] National Eye Institute, US National Institutes of Health
Source:
AMD Alliance International
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