July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Cost-related nonadherence with topical glaucoma medications in patients aged 25-64
Author Affiliations & Notes
  • Dov Kagan
    University of Manitoba, Winnipeg, Manitoba, Canada
  • Yvonne M Buys
    Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Graham Eric Trope
    Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Yaping Jin
    Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships   Dov Kagan, Glaucoma Research Society of Canada (F); Yvonne Buys, Glaucoma Research Society of Canada (F); Graham Trope, None; Yaping Jin, Glaucoma Research Society of Canada (F)
  • Footnotes
    Support  Glaucoma Research Society of Canada Grant
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1989. doi:
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      Dov Kagan, Yvonne M Buys, Graham Eric Trope, Yaping Jin; Cost-related nonadherence with topical glaucoma medications in patients aged 25-64. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1989.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : In Ontario, government assistance is available to patients aged 65+ to cover the costs of many glaucoma medications. This assistance is typically unavailable to Ontarians aged 25-64. This study determined the proportion of glaucoma patients aged 25-64 who lack insurance coverage for topical glaucoma therapy and assessed the frequency of cost-related nonadherence in this population.

Methods : 100 glaucoma patients aged 25-64 who were on topical glaucoma therapy were recruited from two glaucoma clinics in Toronto, Ontario. 100 patients on topical glaucoma therapy aged 65+ were recruited as a control group. Participants were asked to self-report their insurance coverage for glaucoma medications, cost concerns when paying for glaucoma medications, cost-related nonadherence behaviours and socio-demographics in a standardized questionnaire. Participants were deemed to exhibit cost-related non-adherence if they reported that, because of the cost, they failed to fill their medications, delayed filling their medications, or reduced the dosage of their medications in the past year.

Results : 17% (95% confidence interval 11%-26%) of patients aged 25-64 self-reported having no insurance coverage for their glaucoma medications. Of those patients aged 25-64 with coverage, the most common source of insurance was employer-sponsored (70.9%) with 44% requiring a copayment to obtain their eye drops.
Patients aged 25-64 were significantly more likely to report cost concerns when paying for their glaucoma medications than those aged 65+ (25.8% vs 7.1%, p=0.0004). The average copayment was $18 (range $2-$250) in those aged 25-64 compared to $5 in the 65+group (range $0.62-$100). Patients aged 25-64 were also significantly more likely to report at least one form of cost-related nonadherence (15.2% vs 2.1%, p=0.001).
On average, patients aged 25-64 used 3 different types of eye drops daily compared with 2 (p=0.42) different types of eye drops used by those aged 65+. Patients aged 25-64 were significantly more likely to report missing eye drops in a given week than patients aged 65+ (33% vs 17%, p<0.01).

Conclusions : One in six glaucoma patients aged 25-64 do not have insurance coverage for their medication. The cost of glaucoma medications represents a challenge for one in four glaucoma patients in the 25-64 age cohort and contributes to higher nonadherence.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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