Cost of glaucoma care decreases over time

Researchers used claims data from a large managed care network to analyze trends in resource use among open-angle glaucoma (OAG) patients during the first seven years after diagnosis. They used an incidence-based method for estimation of resource consumption to account for cost of care increases or spikes over time.

Unfortunately, potential key cost factors, such as disease severity and medical noncompliance, are difficult to assess in this kind of analysis. Whether or not early glaucoma treatment intervention positively impacts overall healthcare costs is difficult to determine as well.

They found that glaucoma patients consume the greatest relative share of resources during the first six months after diagnosis. Costs stabilized at one year and then remained relatively constant for the next six years. The authors write that although it is impossible to determine from claims data how well-controlled each enrollee's OAG was, the constant rate of resource use suggests that most had relatively stable disease over the course of the follow-up.

Those who used the most resources were younger and more likely to have undergone cataract surgery, have ocular comorbidities, and live in the Northeastern United States. The finding that glaucoma-related charges increased with younger age may indicate that clinicians are more likely to be aggressive at managing glaucoma in younger patients or that patients detected at an earlier age are more likely to have more severe or aggressive disease or a combination of both factors, the authors write. The fact that enrollees who received care in the Northeastern United States used more resources may reflect differential rates of charges in different geographic regions.

The authors conclude that these findings have importance for future evaluations of the cost-effectiveness of screening and treatment of glaucoma.