Racial Disparities Affect Adherence to Glaucoma Medications

Man applying ophthalmology eyedropper, glaucoma eye prevention
Black guy applying ophthalmology eyedropper. Glaucoma eye prevention, human vision serum wash
Clinicians should consider discussing medication costs with patients when treating glaucoma to ensure adherence to treatment.

Patients who self-report as Black or Hispanic have a higher likelihood of stating they are unable to afford glaucoma medications, according to a study published in JAMA Ophthalmology.

Researchers conducted a study to compare self-reported, cost-related barriers to medication adherence by race and ethnicity. They analyzed data of 3826 individuals with glaucoma (60.3% women, 12.6% African American, 3.1% Asian, 9.2% Hispanic, 75.1% White) who participated in the National Institutes of Health’s All of Us research program.

The study population included 396 (10.4%) individuals with Medicaid insurance and 0.1% uninsured patients. A majority of participants (89.5%) had other insurance.

Overall, the team noted that 9.4% of the cohort reported they could not afford medication (18.9% Black, 16.8% Asian, 17.1% Hispanic, 6.8% White) within the past year, while 5.3% skipped medications, 5.9% took less medication, 8.3% delayed filling medication, 19.1% asked for less expensive medication, 3.7% bought medication from another country, and 5.2% used alternative therapies to save money.

Individuals of Black and Hispanic heritage were about 3 times more likely (OR=3.21 and 2.83, respectively) to report not being able to afford medication compared with their peers who were White. 

Participants who were African American were more likely to report skipping medication or taking less medication compared with individuals who were White (10.4% and 5.3%, respectively; P <.001). Patients reporting as White, however, were more likely to report buying medication from another country to save money (3.7%). Respondents of Black and Hispanic heritage were more likely to report delaying filling medication and using alternative therapies to save money compared with individuals who were White or Asian (13.1 and 7.1%; 10.5 and 7.7%; 8.3 and 5.2%; n<20 and n<20, respectively).

After adjusting for age, gender, insurance status, education and income, researchers found that participants who reported as Black or Hispanic were about 80% more likely (OR=1.82 and 1.77, respectively) to report not being able to afford medication, compared with individuals who were White.

The researchers recommended doctors take a proactive stance in ensuring patients have access to necessary medications and state, “Besides changes made on the individual level, the practice of ophthalmology as a whole can help promote health equity by creating a more diverse workforce — which has been shown to improve health outcomes for patients — as well as promoting cost-conscious education among medical students and residents.”

Limitations of the study include a lack of disease severity data for participants and the exclusion of 1597 cases because of missing data.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  


Delavar A, Saseendrakumar BR, Weinreb RN, Baxter SL. Racial and ethnic disparities in cost-related barriers to medication adherence among patients with glaucoma enrolled in the National Institutes of Health All of US research program. JAMA Ophthalmol. Published online March 3, 2022. doi:10.1001/jamaophthalmol.2022.0055