Patients progress from ocular hypertension to glaucoma at high medical cost

WASHINGTON — The first year after the transition from ocular hypertension to glaucoma comes with a considerable medical cost increase for patients, in contrast to those who do not transition, a study found.

Louis R. Pasquale, MD, and colleagues presented findings of a retrospective case-control study of a multi-managed claims database in a poster at the American Glaucoma Society annual meeting. The study examined 1,055 patients from 1998 to 2005 who transitioned from ocular hypertension to primary open-angle glaucoma and a control group of 2,110 patients who did not transition. Dr. Pasquale and colleagues matched age and gender between cases and controls, with 58% women, 42% men and a mean age of 57 years old; however, region, payer type, product type and index year varied case by case.

They found that ocular hypertension patients who progressed to glaucoma had a total ophthalmology-related cost increase in the first year of $797, compared with $385 for controls. They also saw higher increases in total yearly medical charges, $1,689 compared with $1,386 for controls. Adjusting for key covariates, ocular hypertension patients who transitioned to glaucoma were 1.56 times more likely to have increased total charges and 5.26 times more likely to have increased ophthalmology-based charges compared with controls, according to Dr. Pasquale and colleagues.

"It may be cost-effective to keep ocular hypertension patients from transitioning to primary open-angle glaucoma through better patient management with IOP-lowering pharmacotherapies and improved patient-physician communication," they said.