Cost of glaucoma revealed

Sep 26 2012

By Sarah Guy, medwireNews Reporter

The first 6 months after an open-angle glaucoma (OAG) diagnosis are the most costly within the first 2 years of having the condition, report US researchers.

They say that patients in the top 5% of resource use are more likely to be younger, to have ocular comorbidities, to have undergone cataract surgery, and to live in the Northeastern USA, compared with their less-costly counterparts.

"Developing an understanding of the resource use of people with glaucoma and identifying those expected to have the largest resource use is important in a resource-constrained health care environment," said lead author Joshua Stein (University of Michigan, Ann Arbor, USA) in a press statement.

Stein and colleagues examined resource use among participants of the InVision study who used any form of eye care between January 2001 and December 2009. A total of 19,927 participants - who were aged a mean 60 years - had OAG, care of which cost a total US$ 42,333,499 (€ 32,713,704) during the first 2 years after diagnosis.

The costliest 5% of all enrollees in InVision were responsible for $ 10,202,871 (€ 7,883,844), or 24%, of all glaucoma-related charges, note Stein and co-workers, while the least costly 50% of participants amassed only $ 7,986,582 (€ 6,171,299) in charges altogether.

The team reports a "spike" in mean costs during the first 6 months from glaucoma diagnosis, with over one-third (37.8%) of all glaucoma-related charges incurred during this part of the first 2-year period from diagnosis, compared with 21.0% in months 6 to12 after diagnosis, 20.8% in months 12 to 18, and 20.5% in months 18 to 24.

In multivariate analysis, age was significantly associated with cost of glaucoma care, with a 9% decrease in the odds for being in the costliest 5% for every additional 5 years of age. Furthermore, individuals with OAG living in the Southeastern, Western, and Midwestern USA were a respective 22%, 19%, and 35% less likely to be in the top 5% cost bracket compared with those living in the Northeastern USA.

Undergoing cataract surgery within the first 2 years of OAG diagnosis and having diabetic retinopathy or age-related macular degeneration also increased the odds for being in the costliest 5% for glaucoma care, report the authors in the American Journal of Ophthalmology.

"These findings have importance for future evaluations of the cost-effectiveness of screening and treatment of glaucoma," conclude Stein et al.

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