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Tracy Yep, Vaishali D Patel, Julia Slejko, Beth Devine; Comparing Total and Disease Related Healthcare Cost of Glaucoma Patients by Disease Severity: A Retrospective Claims Database Analysis.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2129.
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© ARVO (1962-2015); The Authors (2016-present)
Little is known about the relationship between glaucoma severity and cost. Few studies characterize healthcare costs in glaucoma patients, and none have characterized glaucoma related costs by disease severity. In this study we performed a retrospective database analysis to characterize the total healthcare costs and disease related costs for open-angle glaucoma patients, using ICD-9 disease severity categories.
We analyzed a large US commercial claims database to identify patients 18 years and older with glaucoma occurring in 2011. Inclusion criteria included: two separate occurrences of any combination of open-angle glaucoma (ICD-9 codes 365.10 or 365.11); and presence of a glaucoma severity code in the 12 months after first diagnosis (ICD-9 codes: 365.71, 365.72, 365.73). Patients were excluded for presence of a glaucoma code in the 12 months before first diagnosis. Outcomes of interest were the total healthcare and glaucoma specific costs by disease severity for 12-months post-diagnosis. Generalized linear modeling (GLM) with adjustment for clinically relevant baseline characteristics was used to estimate the mean costs of the mild, moderate, and severe glaucoma categories for both total healthcare and glaucoma specific costs.
899 open-angle glaucoma patients were identified in 2011 who also had an ICD-9 glaucoma severity code (mild n= 542; moderate n= 271; severe n= 86). Glaucoma specific multivariable adjusted GLM results produced mean costs of: $470 (95% CI: $433, $508; p ≤0.001) for mild category, $625 (95% CI: $546, $703; p ≤0.001) for moderate category and $1,037 (95% CI: $781, $1,293; p ≤0.001) for severe glaucoma category. The multivariable adjusted mean total healthcare costs were $5,161 ($4,278, $6,043; p ≤0.001) for mild severity, $5,206 (95% CI: $4,151, $6,261; p ≤0.001) for moderate severity and $10,348 (95% CI: $5,144, $15,552; p ≤0.001) for severe glaucoma severity.
This study demonstrates that glaucoma specific costs and total healthcare costs increase with increasing severity of glaucoma amongst commercially insured patients.
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