Cost of Patients with Primary Open-angle Glaucoma: A Retrospective Study of Commercial Insurance Claims Data
Received 19 June 2006; accepted 10 October 2006. published online 15 February 2007.
Purpose
Primary open-angle glaucoma (POAG) poses a large burden on eye care resources in the United States. We evaluated the total health care and POAG-specific charges (both pharmacy and nonpharmacy) incurred by patients with POAG using a longitudinal U.S. commercial insurance claims database to determine the relative magnitude of glaucoma care charges to overall health care charges for those patients with glaucoma.
Design
Retrospective cohort design.
Participants
Sixty-four thousand three hundred eighty patients with POAG were identified.
Methods
Patients with POAG were selected (International Classification of Diseases, 9th Revision code 365.11 on at least 2 encounters) from a managed care claims database. Total health care and POAG-specific charges were calculated. Component charges (pharmacy and nonpharmacy) also were evaluated and the charge per treated person was calculated.
Main Outcome Measure
Health care charges.
Results
The mean total health care charges per person in the first year after initial entry into the database with POAG were $13 404 (standard deviation [SD], $33 987), with a median charge of $5403. The mean POAG-specific charge per person was $1570 (SD, $3428), with a median charge of $840. Pharmacy charges were 25% of the POAG-specific charges. The POAG-specific charges in subsequent years after the initial year decreased by 7% per year, whereas the total health care mean charge increased by 39% per year. Patients aged 65 years and older had significantly higher mean charges for both total health care charges ($16 759 vs. $11 651; P<0.0001) and POAG-specific charges ($1624 vs. $1542; P = 0.0049), for an age-related increase of 44% for total charges and 5% for POAG-specific charges. Overall, POAG-specific mean charges represented 12% of total mean charges in the first year and 8% of total overall mean charges in subsequent years.
Conclusions
There is a substantial cost burden associated with POAG in a population with commercial insurance, and most of these charges are not pharmacy related.
1Duke University Eye Center, Durham, North Carolina.
2University of Wisconsin Medical School, Madison, Wisconsin.
3Global Health Outcomes Strategy and Research, Allergan, Inc., Irvine, California.
ABSTRACT