Patient and Economic Burden of Presbyopia: A Systematic Literature Review

Abstract

John Berdahl,1 Chandra Bala,2 Mukesh Dhariwal,3 Jessie Lemp-Hull,4 Divyesh Thakker,5 Shantanu Jawla5 1Vance Thompson Vision, Sioux Falls, SD, USA; 2Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; 3Global Health Economics & Outcomes Research, Alcon Vision LLC, Fort Worth, TX, USA; 4Clinical Development and Medical Affairs, Alcon Vision LLC, Fort Worth, TX, USA; 5Patient Access Services, Novartis Healthcare Pvt Ltd., Hyderabad, Telangana, IndiaCorrespondence: Dr Mukesh DhariwalAlcon Vision LLC, 6201 South Freeway, TA3-8, Fort Worth, TX 76134-2099, USATel [phone]Fax [phone]Email [email protected]: The objective of this systematic literature review (SLR) was to collate, report, and critique published evidence related to epidemiology and patient and economic burden of presbyopia.Patients and Methods: A systematic literature search was conducted in MEDLINE®, Embase®, and Cochrane Library databases from the time of inception through October 2018 using Cochrane methodology. Studies published in English language reporting on epidemiology and patient and economic burden of presbyopia were included.Results: Initial systematic literature search yielded 2,228 citations, of which 55 met the inclusion criteria (epidemiology, 44; patient burden, 14; economic burden, 1) and were included in this review. Globally, 1.09 billion people are estimated to be affected by presbyopia. The reported presbyopia prevalence varied across regions and by age groups, with the highest prevalence of 90% reported in the Latin America region in adults ≥ 35 years. Presbyopic patients report up to 22% decrease in quality-of-life (QoL) score, and up to 80% patients with uncorrected presbyopia report difficulty in performing near-vision related tasks. About 12% of presbyopes required help in performing routine activities, and these visual limitations reportedly induce distress and low self-esteem in presbyopia patients. Uncorrected presbyopia led to a 2-fold increased difficulty in near-vision-related tasks and a > 8-fold increased difficulty in very demanding near-vision-related tasks. Further, uncorrected presbyopia leads to a decrement in patients’ QoL, evident by the low utility values reported in the literature. Annual global productivity losses due to uncorrected and under-corrected presbyopia in working-age population (< 50 years) were estimated at US$ 11 billion (0.016% of the global domestic product (GDP) in 2011, which increased to US$ 25.4 billion if all people aged < 65 years were assumed to be productive.Conclusion: Uncorrected presbyopia affects patients’ vision-related quality of life due to difficulty in performing near-vision-related tasks. In addition, un-/under-corrected presbyopia could lead to productivity losses in working-age adults.Keywords: presbyopia, burden of disease, quality of life, productivity loss, patient satisfaction, utilities

Keywords

• presbyopia
• burden of disease
• quality of life
• productivity loss
• patient satisfaction
• utilities