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Siddarth Rathi, Chris Andrews, David S Greenfield, Joshua D Stein; A COMPARISON OF RESOURCE USE AND COSTS FOR PATIENTS WHO ARE NEWLY DIAGNOSED WITH EXFOLIATION SYNDROME GLAUCOMA VERSUS PRIMARY OPEN-ANGLE GLAUCOMA. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5046.
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The purpose of this study was to characterize differences in resource utilization patterns and health care costs for patients with incident exfoliation glaucoma (XFG) compared to primary open-angle glaucoma (POAG) in the United States.
Claims data from a 20% sample of Medicare enrollees throughout the US were analyzed to identify all persons age ≥ 65 who were continuously enrolled in Medicare for ≥5 years and were newly diagnosed with POAG or PXG during 2008-2014. Persons with pre-existing POAG or XFG during a three year lookback period were excluded as well as those who had records of medical, laser, or surgical glaucoma treatment during this three year period. Persons newly diagnosed with POAG or XFG and received ≥1 confirmatory diagnosis were followed for two years. Resource utilization and costs associated with visits, diagnostic procedures, medications, cataract and incisional glaucoma surgery were captured during the two year timeframe.
There were 223 persons with newly diagnosed XFG (73% female) and 8366 persons with newly-diagnosed POAG (65% female) who met the inclusion criteria. Persons with POAG had slightly more office visits (mean 7.5 POAG, 6.4 XFG; p<0.001) over the first 2 years. The proportion of patients treated with glaucoma medications was greater in the POAG group (79% vs. 41%, p=0.00) while the proportion of persons undergoing laser trabeculoplasty (12.8% POAG vs. 9.8% XFG, p=0.18) and incisional glaucoma surgery (16% POAG vs. 12% XFG, p=0.11) were similar between groups. A greater proportion of persons with XFG underwent cataract surgery (25.5% vs. 18.3%, p=0.006) in the first two years. The mean total cost of care per person was higher in the XFG group ($2464 ± 2760) vs POAG ($2371 ± 2058, p=0.02).
Newly diagnosed POAG patients utilize clinic and operative glaucoma resources more frequently compared to XFG patients. However, XFG patients have cataract surgery earlier and incur higher average costs compared to POAG patients. Further research is needed to elucidate differences in utilization and costs of care beyond initial diagnosis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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