Glaucoma treatment time and costs increase as disease progresses

Delaying the progression of the eye disease glaucoma from advancing to later stages is associated with lower cost of care, according to a study in the January issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Glaucoma affects an estimated 2.2 million Americans older than age 40 years, half of whom remain undiagnosed, the authors provide as background information in the article. "The incidence of glaucoma is expected to rise with the growth of the elderly population. Glaucoma costs the U.S. health care system an estimated $2.5 billion annually: $1.9 billion in direct costs and $0.6 billion in indirect costs," the authors write. Glaucoma is an eye disease characterized by damage to the optic nerve and loss of vision, usually the result of high pressure in the eye.

Paul P. Lee, M.D., J.D., from Duke University Medical Center, Durham, N.C., and colleagues analyzed 151 records of patients with primary open-angle or normal-tension glaucoma, glaucoma suspect, or ocular hypertension to determine if use of physician and other services for low vision care and vision rehabilitation, and direct costs of care increased with progression of disease severity.

"Direct ophthalmology-related resource use, including ophthalmology visits, glaucoma surgeries, and medication use, increased as disease severity worsened," the researchers found. "Average direct cost of treatment ranged from $623 per patient per year for glaucoma suspects or patients with early-stage disease to $2,511 per patient per year for patients with end-stage disease. Medication costs composed the largest proportion of total direct cost for all stages of disease." The researchers add that glaucoma is "generally asymptomatic or nonspecific in its symptoms in its earlier phases, resulting in delayed diagnosis and relatively increased medical vigilance throughout the later stages of the disease."

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In conclusion, the authors write: "Based on these findings, a glaucoma treatment that delays the progression of disease could have the potential to significantly reduce the health economic burden of this chronic disease over many years."
(Arch Ophthalmol. 2006;124: 12 – 19. Available to the media pre-embargo at www.jamamedia.org.)

Editor's Note: This study was supported by an unrestricted grant from Allergan, Inc., Irvine, Calif.


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