September 17, 2012
Study examines costs of caring for patients with open-angle glaucoma in the United States
Findings lead to identification of factors that influence costliest 5% of patients receiving glaucoma-related care
Researchers at the University of Michigan Kellogg Eye Center have discovered that a small subset of patients with open-angle glaucoma (OAG), the most common form of glaucoma in the United States, account for a large proportion of all glaucoma-related charges. These findings have importance for future evaluations of the cost-effectiveness of screening and treatment of glaucoma.
"We've identified risk factors associated with patients who are the costliest recipients of glaucoma-related eye care," says Joshua D. Stein, M.D., M.S., glaucoma specialist at Kellogg. "Among these factors are younger age, living in the northeastern United States, undergoing cataract surgery, and having other eye conditions. Understanding the characteristics of these individuals and finding ways to reduce disease burden and costs associated with their care can result in substantial cost savings."
The study, published in the American Journal of Ophthalmology, September 2012, reviewed claims data from 19,927 patients with newly diagnosed OAG enrolled in a large United States managed care network to identify glaucoma-related charges for all incident OAG patients from 2001 through 2009. Findings revealed that the costliest 5% of enrollees were responsible for $10,202,871, or 24%, of all glaucoma-related charges. Glaucoma patients generally consume the greatest relative share of resources during their first 6 months of care after diagnosis.
"Although there have been several studies examining the cost of caring for patients with glaucoma, most have been based on individuals with prevalent OAG, and few have examined changes in cost of care over time," says Dr. Stein. "In this investigation, we examined two questions: What is the pattern of resource use for patients with OAG during the first 7 years after disease onset, and what are the characteristics of those patients who have the greatest glaucoma-related resource use?"
A chronic, progressive, incurable disease that affects more than 2 million individuals in the United States and many more worldwide, OAG is the most common cause of blindness among African Americans. Caring for patients with OAG in the United States carries a total societal cost estimated at nearly $1 billion annually.
"Developing an understanding of the resource use of people with glaucoma and identifying those expected to have the largest resource use is important in a resource-constrained health care environment," says Dr. Stein. "Further, by collecting longitudinal information on resource use we can better quantify the value of slowing glaucoma progression through various interventions."
Longitudinal Trends in Resource Use in an Incident Cohort of Open-Angle Glaucoma Patients: Resource Use in Open-Angle Glaucoma. American Journal of Ophthalmology, September, 2012.
Joshua D. Stein, M.D., M.S.; Leslie M. Niziol, M.S.; David C. Musch, Ph.D., M.P.H.; Paul P. Lee, M.D., J.D.; Sameer V. Kotak, M.S.; Colleen M. Peters, M.A.; Steven M. Kymes, Ph.D.
Written by Barbara Wylan Sefton