July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Clinical presentation, comorbidities and healthcare utilization of patients with dry eye and Meibomian gland dysfunction – a United States database analysis
Author Affiliations & Notes
  • Jill Ruppenkamp
    Johnson and Johnson, Raynham, Massachusetts, United States
  • Ekoue Folly
    Johnson and Johnson, Raynham, Massachusetts, United States
  • Chantal Holy
    Johnson and Johnson, Raynham, Massachusetts, United States
  • Caroline A Blackie
    Johnson and Johnson Vision, North Andover, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jill Ruppenkamp, Johnson and Johnson (E); Ekoue Folly, Johnson and Johnson (E); Chantal Holy, Johnson and Johnson (E); Caroline Blackie, Johnson and Johnson Vision (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2737. doi:
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      Jill Ruppenkamp, Ekoue Folly, Chantal Holy, Caroline A Blackie; Clinical presentation, comorbidities and healthcare utilization of patients with dry eye and Meibomian gland dysfunction – a United States database analysis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2737.

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

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Purpose : Meibomian Gland Dysfunction (MGD) is a common condition leading to dry eye and general ocular surface compromise. Clinical trial data suggests a prevalence of nearly 50% in the elderly. Despite high disease state prevalence, there is an absence of published reports of patient pathways, diagnostics and treatments, and overall healthcare utilization (HCU), when diagnosed with MGD.

Methods : The IBM MarketScan® Commercial and Medicare databases were queried. Patients with MGD and dry eye were identified. All patients had at least 12 months continuous medical and prescription drug enrollment pre- and 6 months post-index. Charlson and Elixhauser comorbidity indices as well as ocular conditions and presence of Sjögren’s disease were analyzed for all patients. The HCU related to ocular conditions were analyzed and yearly payments for eye care were calculated and adjusted for inflation using 2017 consumer price-index.

Results : 2,738 commercially-insured and 965 Medicare patients were included, 82.5% > 45 years, 69.3% female, 29% with Elixhauser index > 2. Comorbidities included hypertension (38.7%), hypothyroidism (18.1%), diabetes (13.4%), depression (14.6%) and chronic pulmonary disease (14.2%). Ocular conditions identified at index were: cataract: 19.2%, glaucoma: 9.6%, conjunctiva-related disorders (CRD): 13.2%, lachrymal system disorders (LSD): 74.0%. At 12 months post-index, CRD and LSD were still reported for 14.6% patients and 45.4% patients, respectively. In the 12-months post-index, only 49.3% patients had a subsequent eye exam (43.5% of commercially-insured and 65.2% Medicare patients), during which diagnostic procedures for tears analysis and dry eye were only performed on 12.7% patients (12.6% commercially-insured and 13.1% Medicare patients). From index to 12 months post, all eye-care related healthcare (excluding drugs) averaged US$ 288.73 (standard deviation (SD): $1,224.6) for commercially insured and US$ 639.07 (SD: $1,972.51) for Medicare patients.

Conclusions : Patients diagnosed both dry eye and MGD were mostly older than 45, with multiple comorbidities. In stark contrast to the high disease prevalence reports in the peer reviewed literature, MGD and dry eye patients appear to receive a bare minimum of diagnostic testing and follow-up care.

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


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