Oct. 31, 02 - Prescribing high doses of vitamin supplements to aging baby boomers with vision loss due to macular degeneration – the leading cause of blindness in patients over 50 years old – could save the North American health care system more than $1.5 billion in the next 10 years, a Queen's University researcher has discovered.

Dr. Sanjay Sharma, founding director of the university's Cost-Effective Ocular Health Policy Unit, presented his findings in a "highlighted paper" at the annual meeting of the American Academy of Ophthalmology in Orlando, Florida. His new approach to improving health-care decision-making looks at the degree to which a particular treatment improves a medical condition and how much that treatment will cost the health-care system.

"Our results demonstrate that the use of high-dose vitamin supplementation (Vitamins C and E, plus beta carotene and zinc) by people suffering from age-related macular degeneration will result in both improved quality of life and reduced health-care costs," says Dr. Sharma. "We project that this strategy, if applied to those with the advanced 'dry' form of AMD over the coming decade could potentially save the North American health care system more than $1.5 billion. This would result from the anticipated reduction in demand for more expensive technologies used to treat the 'wet' form of AMD, which can progress from the dry form."

Since many insurance companies don't list high-dose vitamin supplementation as a benefit, patients may not receive this form of prevention, he adds.

A professor of ophthalmology, and community health and epidemiology at Queen's, Dr. Sharma has developed a new approach to health care decision-making based on both effectiveness and scientific evidence. His mathematical models combine quality-of-life measurements with statistical information about the success of both traditional and innovative new treatments, in this case with vitamins.

Using data gathered over seven years by the U.S. National Eye Institute from national, randomized clinical trials (the Age-Related Eye Disease Study), as well as his own quality of life inputs and data from several other studies, Dr. Sharma created a model to determine the value of various treatments, including high-dose vitamin supplementation, and their effects on patients' quality of life.

The results demonstrated that vitamin therapy for patients with the moderately advanced form of "dry" AMD is an extremely cost-effective strategy when used to prevent disease progression.

"The cost of drugs and medical services in Canada and the U.S. has gone up tremendously in the past decade," says Dr. Sharma. "What we need is a rational system for deciding which drugs to cover under government-subsidized or private insurance plans. We're creating models to look at this, and at the value of these treatments for eye disease."

Dr. Sharma's research has been funded by the Canadian Institutes for Health Research (CIHR) and the Canadian Foundation for Innovation (CFI). No part of the project was funded by a pharmaceutical company or insurer.