Abstract
Purpose: :
European studies have identified primary open angle glaucoma (POAG) as the second leading cause of blindness, accounting for 8–10% of blindness in older people. The objective of this study was to estimate the societal costs and the quality of life among patients with late stage POAG.
Methods: :
Charts of late stage POAG patients in France and Denmark were reviewed and the patients were interviewed. Total costs were calculated from registered resource. Utility values of health related quality of life were based on EQ–5D, using Danish weights for both Denmark and France, as no French weights currently exist.
Results: :
A total of 81 patients were included. In France the average late stage glaucoma patient had POAG–related annual health care resource use of €833 (SD: 236). In Denmark the average costs per patient were €918 (SD: 642). In France the largest contributor to health care costs was visits to vision rehabilitation centres, while medication was the largest in Denmark. The most important cost item in both countries is the cost of home help. The average cost of home help is €3,806 and €3,141 per patient per year, in France and Denmark respectively. On average, the health related quality of life average score is 0.65 (0.61 in France and 0.67 in Denmark). In France the health related quality of life decrease in line with visual acuity, measured by Snellen score. Visual acuity (on the better eye) is predictive (p=0.025) for lower health related quality of life. This is not the case in Denmark.
Conclusions: :
This study shows that late stage glaucoma is associated with considerable health care and – in particular – social care costs (home help). There is strong evidence that the recorded proportion of patients in need for home help is much higher than in the general population. It is likely that early treatment with the potential to prevent disease progression would be a cost–effective, or maybe even cost saving, intervention. Besides the costs, late stage glaucoma also influences health related quality of life. Generally, quality of life of late stage glaucoma patients is relatively low with a mean of 0.65, where 0 is equal to death and 1 is perfect health. The costs of late stage glaucoma are fairly similar in France and in Denmark, however, a small difference in utility–levels were detected.
Keywords: low vision • intraocular pressure • visual acuity