Economic Burden and Cost-Effectiveness of Management of Non-Infectious Uveitis: A Systematic Review.

Purpose: To evaluate the economic burden and cost-effectiveness of interventions and management of non-infectious uveitis (NIU).

Methods: A comprehensive search was conducted across Medline, Embase, and Scopus databases from inception to March 2023. Risk of bias assessments were conducted using the Joanna Briggs Institute critical appraisal tools.

Results: A total of 24 articles consisting of 16 economic burden studies (67%) and 9 cost-effectiveness or cost-utility studies (38%) met the inclusion criteria. Annual direct medical costs ranged from $16,428 to $134,135 USD 2023, with costs being 4.3 times higher for those with blindness compared to those without vision loss. Direct medical costs for corticosteroid, immunosuppressive, and biologic therapies were $19,497, $29.979, and $45,830, respectively. Indirect costs ranged from $806 to $57,170, with costs being 2.1 times higher for persistent NIU and 2.3 times higher for those with blindness. Annual medication and intervention costs ranged from $345 to $13,134, with prescription drug costs being 60% higher for blind patients compared to those with moderate vision loss. Overall, cost-effectiveness analyses show promise for treatments like adalimumab and certain implants, though the extent of economic benefit depends on price reductions and healthcare system variations. Varying parameters like willingness-to-pay (WTP) thresholds and input parameters further complicated comparability.

Conclusions: NIU poses a significant economic impact, particularly in patients with blindness and those on advanced therapies. While evidence is growing in Western countries like the US and UK, further research in non-westernized countries is warranted for a comprehensive, global understanding of the disease's economic burden.