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Peter Y Zhao, Raheem Rahmathullah, Alan L Robin, Joshua D Stein; Comparison of Prices of Glaucoma Medications, Laser Trabeculoplasty, and Incisional Glaucoma Surgery in 20 Countries. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3738.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma is a leading cause of blindness worldwide and a substantial public health burden. Cost is an important consideration in glaucoma management, and high costs may deter patients from seeking care, especially in developing nations where patients may have limited financial means. We compared the prices of different glaucoma interventions in 20 nations.
We obtained prices for glaucoma medications, laser trabeculoplasty (LTP), and incisional glaucoma surgery using government pricing data, drug databases, academic publications, and communications with local ophthalmologists. When different prices for interventions were obtained from multiple sources in one country, mean prices were calculated. Prices for each intervention were adjusted for inflation and purchasing power parity to 2016 USD, and compared to median annual household incomes for each country.
Of the 20 countries, 12 were developing nations and 8 were developed nations. We used an average of 2 data sources per country. Price of a one-year supply of generic latanoprost relative to median annual household income ranged from 0.1% in Switzerland to 30.8% in Ethiopia, and was 1.3% in the US. Price of a one-year supply of generic timolol relative to income ranged from 0.1% in the UK to 3.7% in South Africa (0.3% in the US). Price of LTP relative to income ranged from 0.2% in Switzerland to 11.4% in India (1.6% in the US). Price of trabeculectomy relative to income ranged from 1.2% in Canada to 18.3% in India (6.5% in the US). In some developing countries, the price of bilateral LTP approached the price of one year of prostaglandin therapy.
Cost of glaucoma treatment relative to median annual household income was overall higher in developing countries. Timolol was the most affordable topical medication in all countries studied. Cost of treatment in the USA was high for a developed country. Cost of care has been shown to influence not only adherence but also utilization of care. Ophthalmologists should consider costs when developing a therapeutic plan, especially when working in resource-limited settings.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Table 1: Unit prices of most affordable topical glaucoma medication available in each drug class by country.
Figure 1: Prices for generic latanoprost divided by the median annual household income in each country and expressed as a percentage. For Ethiopia (30.80%), bar length was truncated.
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