Direct costs of glaucoma and severity of the disease: a multinational long term study of resource utilisation in Europe

Abstract

Background: Resource utilisation and direct costs associated with glaucoma progression in Europe are unknown. As population progressively ages, the economic impact of the disease will increase. Methods: From a total of 1655 consecutive cases, the records of 194 patients were selected and stratified by disease severity. Record selection was based on diagnoses of primary open angle glaucoma, glaucoma suspect, ocular hypertension, or normal tension glaucoma; 5 years minimum follow up were required. Glaucoma severity was assessed using a six stage glaucoma staging system based on static threshold visual field parameters. Resource utilisation data were abstracted from the charts and unit costs were applied to estimate direct costs to the payer. Resource utilisation and estimated direct cost of treatment, per person year, were calculated. Results: A statistically significant increasing linear trend (p = 0.018) in direct cost as disease severity worsened was demonstrated. The direct cost of treatment increased by an estimated J86 for each incremental step ranging from J455 per person year for stage 0 to J969 per person year for stage 4 disease. Medication costs ranged from 42% to 56% of total direct cost for all stages of disease.Conclusions: These results demonstrate for the first time in Europe that resource utilisation and direct medical costs of glaucoma management increase with worsening disease severity. Based on these findings, managing glaucoma and effectively delaying disease progression would be expected to significantly reduce the economic burden of this disease. These data are relevant to general practitioners and healthcare administrators who have a direct influence on the distribution of resources.

The clinical effectiveness and cost-effectiveness of screening for open angle glaucoma: a systematic review and economic evaluation

“…When each of these scales was applied to the same cohort of patients the rates of apparent progression varied according to which scoring scale and definition of progression were used. 257,258 A modified version of the glaucoma severity scale used by a study group examining the costs of glaucoma treatment by stage in Europe and the USA was used for this study 259,260 (Table 27). This scale itself was a modification of the Hodapp-Anderson-Parrish scale.…”

Cost-effectiveness comparison between non-penetrating deep sclerectomy and maximum-tolerated medical therapy for glaucoma within the Brazilian National Health System (SUS)

“…Glaucoma direct costs have a major impact on health care, be cause it includes: chronic use of medications, surgical procedures, medical visits and frequent exams (6) . Glaucoma chargers are respon sible for up to 12% of all medical expenses in glaucoma patients (7) .…”

“…Glaucoma chargers are respon sible for up to 12% of all medical expenses in glaucoma patients (7) . Medica tions contribute with a significant proportion of glaucoma re lated direct costs (6) . Rylander and Vold estimated the annual costs with a single medication in the United States.…”

Cost-effectiveness of early detection and treatment of ocular hypertension and primary open-angle glaucoma by the ophthalmologist

“…Other published glaucoma cost studies show comparable estimates for yearly costs in Europe and Canada. [45][46][47] In the US the published yearly costs ranged from h486 for early stage of the disease to h1960 for patients with end-stage disease. 48 Differences in unit costs, in medication prices, in the assignment of laser The incremental cost-effectiveness ratio shows extra costs per effect in comparison with the strategy 'tonometry no one' (ratio between the difference in costs and the difference in effects).…”