Glaucoma patients who take their medications on a regular basis enjoy a better quality of life, and a new study shows this benefit comes with a relatively low increase in their lifetime healthcare costs compared with those who aren’t compliant with their meds.
A team of researchers conducted a cost-analysis that compared optimal to poor glaucoma medication adherence. They found the total healthcare costs for compliant patients averaged $62,782 compared with $52,722 for those who didn’t take their medications on a regular basis—or an approximate $10,000 difference.
The investigation used data from the United Kingdom Glaucoma Treatment Study and included patients who were 40 and older with a full life expectancy. The subjects started out with a mean deviation in the better-seeing eye of -1.4 ±-1.9dB and -4.3±-3.4dB in the eye with worse vision.
Participants whose vision deteriorated each year accumulated -0.8dB loss compared with -0.1dB loss for those who remained stable. The investigation also used data from the Glaucoma Laser Trial and the Tube vs. Trabeculectomy studies to assign probabilities of worsening disease among treated patients and claims data estimating rates of glaucoma medication adherence over four years to assign probability of adherence. As patients’ mean deviation deteriorated, they transitioned between health states from mild (≥-6dB), to moderate (<-6dB to ≥-12dB) to severe glaucoma (<-12dB to ≥23dB) to unilateral (<-20dB) and bilateral blindness. The study calculated the cost of treatment at each health state.
Beginning at an initial glaucoma diagnosis at age 40, patients progressed to single-eye blindness as early as 19 years among those who were non-adherent and 23 years for those who remained compliant.
The study also noted non-adherent patients had a loss of about a 0.34 quality-of-life years (QALY), which resulted in approximately $29,600 per QALY gained.
At a conservative estimate of $50,000 for those who were noncompliant, there is much room to expand services to improve patient adherence, the researchers suggested.
This is the first study to model the cost-effectiveness of improving glaucoma medication adherence from a societal perspective, the study noted.
“From even a conservative cost-effectiveness standpoint, there is opportunity to allocate more resources to improving adherence while remaining highly cost-effective,” the researchers wrote in their paper. “Therefore, it is imperative to focus on developing cost-effective programs to better support people in taking their glaucoma medications on time, every day.”
|Newman-Casey PA, Salman M, Lee PP, Gatwood J. Cost utility analysis of glaucoma medication adherence. Ophthalmology. October 10, 2019. [Epub ahead of print].|