Substantial Incremental Economic Health Care Burden Associated With Glaucoma

Patients with glaucoma incur an annual incremental economic burden of $1863.17, which equates to $9.2 billion nationally, according to a study published in the Journal of Glaucoma.

Researchers estimated the incremental health care burden (defined as “health care expenditures for a patient solely due to the diagnosis of a condition and independent of their sociodemographic characteristics and other comorbidities”) of patients diagnosed with glaucoma by conducting a retrospective, cross-sectional analysis of adult participants of the Medical Expenditure Panel Survey (MEPS) between 2016 and 2018.

They estimated incremental glaucoma expenditures in aggregate and by sociodemographic subgroups and health care service sector using a linear regression model. Inpatient, outpatient, emergency room, home health, and medication expenditures were included in the analysis. 

Investigators included data from 1521 patients with glaucoma and 4563 patients without glaucoma. Incurred mean expenditures were $13,585.68±1367.03 and $12,048.92±782.49, respectively. A higher proportion of participants with glaucoma were women, advanced in age, publicly insured through Medicare or Medicaid, college educated, identified as non-Hispanic, resided in the Northeast, and had more comorbidities (P ≤.002 for all) compared with patients without glaucoma. No significant differences were observed in health care burden based on gender, income, insurance status, education, and year of care received among patients with glaucoma. 

After controlling for comorbidities and socioeconomic factors, the investigators found that propensity-matched patients with glaucoma incurred an annual incremental health care burden of $1863.17 (95% CI 393.44-3117.23, P =.013). On a national level, this equates to $9.2 billion. Further analysis revealed that prescription medication cost was the greatest contributor to total expenditures (expenditure ratio, 1.20, 95% CI, 1.02-1.42, P =.031).

“Glaucoma patients have a substantial incremental economic health care burden after accounting for demographics and comorbidities, largely secondary to prescription medications,” according to the researchers. “There is a need to continue identifying and studying treatment options for patients with glaucoma to maintain vision while minimizing health care expenditures.” 

Limitations of the study include a lack of information on disease subtype and severity in the MEPS database, potential bias resulting from the observational, cross-sectional design, potential over or underrepresentation of certain comorbidities, and inability to account for individuals with glaucoma that have not yet been diagnosed.

Reference

Rasendran C, Li A, Singh RP. Incremental health care expenditures associated with glaucoma in the United States: a propensity score-matched analysis. J Glaucoma. 2022;31(1):1-7. doi:10.1097/IJG.0000000000001957