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Gabriel Lazcano-Gomez, Jesus Jimenez-Roman, GLAUCOMA APEC; Cost of glaucoma in the XXI century. Economic Analysis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3491.
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To determine the economic cost of patients diagnosed with primary open-angle glaucoma in medical monitoring over a 5 year period.
Patients with POAG who had at least 5 years of follow up were included. Data collected from the record included glaucoma treatment, as well as number of hospital visits, diagnostic studies, laser or surgical treatments for each patient in a 5 year period. A questionnaire including study level, current employment status, monthly income and monthly cost of glaucoma drops was answered by all the patients. We calculated monthly cost for each brand name of glaucoma drops. Costs of hospital visits, studies and treatments were also calculated. After reviewing the number of visits, studies and surgeries for each patient, we multiplied them by the price obtained from the list of our hospital costs, in order to know the total cost per patient over a 5 year period.
We included 462 patients with POAG, (86 men and 376 women). The average age was 70.04 ± 10.19 years. Total cost of glaucoma drops per patient in 5 years was $2,899.69 ± $1,771.15, while the cost referred by the patients was 3,368.65±$384.90. Total cost per patient during 5 years period including direct costs (visit cost, diagnosis studies, laser or surgical treatments and glaucoma drops cost) and indirect costs (transportation cost) was $6,634.13 ± $2,744.28. The income for each patient, in a 5 year period was $15,959.20 ±$233.76. A total of 245 patients (53%) were unemployed and from them, 51 patients (20%) because of the low visual acuity caused by glaucoma.
Monotherapy with prostaglandins analogue was the most prescribed first therapy treatment at the time of diagnosis, but at the end of the 5 year period, fixed combinations were the most prescribed therapy. This is important, as the total cost of drops represents 47.78% of the total cost; followed by the cost on surgeries ($2,204.36±$421.12), representing 36% of the total cost ($6,634.13±$2,744.28). We also noted that almost 50% of the study population had a basic educational level to intermediate (primary, secondary and technical career). Educational and labor conditions are the cause that the income received by most patients, are very close to the minimum wage in our country. Therefore, we conclude that 41% of the total income of patients with POAG, is spent in the treatment of the disease, which is a very high cost for such patients.
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