title: Cost of glaucoma in Canada: analyses based on visual field and physician's assessment.
abstract: OBJECTIVE
  A longitudinal, retrospective study investigated the cost of primary open angle glaucoma (POAG).
  
  
  METHODS
  Patient files from two tertiary care glaucoma practices were reviewed. Patients diagnosed with POAG and >/=2.5 years of follow-up data were included. Data collected included visual field mean deviation, physician's assessment, and resource utilization (physician visits, procedures, and medications). Costs, reported in 2001 Canadian dollars, were compared between groups, based on initial visual field mean deviation, including mild (<5 dB), moderate (5 to <12 dB), and severe (>/=12 dB), and based on physician's assessment, including controlled, uncontrolled, or patients initially uncontrolled for 12 months who become controlled.
  
  
  RESULTS
  Of 411 patient charts extracted, 265 were included; 35 were excluded for ocular comorbidities and 111 patients with insufficient follow-up. Mean (standard deviation) yearly costs overall (N = 265) and for mild (n = 90), moderate (n = 91), and severe (n = 84) groups were $508 ($278), $408 ($266), $512 ($288), and $609 ($243), respectively. Differences between mean yearly costs were statistically significant for all three groups (P < 0.05). Costs for controlled (n = 110), uncontrolled (n = 76), and uncontrolled then controlled group (n = 79) were $423 ($243), $594 ($314), and $542 ($256), respectively. The controlled group cost was significantly lower than both of the other groups (P < 0.05).
  
  
  CONCLUSIONS
  The cost of treating POAG increases with visual field mean deviation severity and uncontrolled disease. Many patients diagnosed with glaucoma had already progressed to later stages in the disease process. Early disease detection may provide a substantial cost savings to the health care system.
authors.affiliation: PharmIdeas Research and Consulting Inc. Canada. skedji@phamideas.com
authors.forename: Michael
authors.initials: M
authors.lastname: Iskedjian
authors.forename: John
authors.initials: J
authors.lastname: Walker
authors.forename: Colin
authors.initials: C
authors.lastname: Vicente
authors.forename: Graham E
authors.initials: GE
authors.lastname: Trope
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Buys
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Einarson
authors.forename: David
authors.initials: D
authors.lastname: Covert
mesh_terms: D002170:Canada; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics; D004470:Economics, Medical; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000191:economics* / Q000503:physiopathology / Q000628:therapy; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000191:economics; D012189:Retrospective Studies; D014794:Visual Fields