Medical predictive factors of glaucoma treatment costs.
OBJECTIVE
To describe the patterns and the economics of glaucoma treatment.


METHODS
Ophthalmologists selected at random were asked to include 4 consecutive patients over 18 years of age seen in consultation during a week. Socio-demographics, general and eye comorbidities, glaucoma risk factors, clinical data, and medical item consumption data for the preceding 5 years were collected for each patient. The economic perspective was societal, and predictive medical factors of costs were identified using a stepwise regression.


RESULTS
Eighty-eight ophthalmologists included 337 patients, with a gender ratio of 4 males to 6 females, and a mean age of 62. Thirty-four percent had OHT. Glaucoma patients were older and no difference was found on the known confounding factors. Patients with glaucoma visited practitioners more often than those with OHT, had more exams, more often used expensive drug combination therapies, and had more hospitalizations. Drugs represented 37.1% to 63.1% of the expenses followed by exams (17.7% to 34.3%) and visits (13.8% to 28.0%). Two clinical factors contributed to costs: abnormalities of the optic nerve head the day of the study visit and the number of treatment changes. These were followed by intraocular pressure (IOP) and visual acuity.


CONCLUSIONS
Two major independent factors explained the bulk of total cost variance: drug treatment changes and the presence of glaucoma instead of OHT. They contributed independently in an additive way to total cost.
Denis
Philippe
P
Hôpital Edouard Herriot, Service d'ophtalmologie, Lyon, France.
Lafuma
Antoine
A
Berdeaux
Gilles
G
D000959:Antihypertensive Agents / Q000191:economics; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000191:economics; D004470:Economics, Medical; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000191:economics*; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy / Q000191:economics; D012189:Retrospective Studies
D000959:Antihypertensive Agents