Consider cost-effectiveness of treatment when managing glaucoma
Key takeaways:
- The impact of cost must be considered when selecting a glaucoma treatment.
- Earlier glaucoma diagnosis and treatment will reduce costs.
Ophthalmologists must consider the cost-effectiveness of available treatment options for glaucoma and the impact this may have on patients, according to a speaker at the American Glaucoma Society meeting.
In the U.S., the cost of glaucoma medication was $2.7 billion per year by 2021, and while the U.S. accounts for 4.2% of the world’s population, it utilizes approximately 39% of glaucoma medication worldwide, Lama Al-Aswad, MD, MPH, of the University of Pennsylvania Perelman School of Medicine, said. These treatment regimens are often time-consuming for patients, leading to poor adherence and a negative impact on quality of life.
“Now, should we be thinking of other ways of managing our patients that is better for quality of life and less expensive?” Al-Aswad said.
Laser surgery studies have shown efficacy in treating open-angle glaucoma and ocular hypertension while providing better long-term disease control than eye drops. In fact, Al-Aswad and colleagues found that laser peripheral iridotomy was cost-effective in primary angle-closure suspects in 24.65% of iterations at 2 years and 92.69% of iterations at 6 years.
“If there is a problem understanding when to do laser or not, can we use cost to help direct us?” Al-Aswad said.
The global market size for MIGS procedures was estimated to be $539.6 million in 2023, with the U.S. accounting for 36% of that, according to Al-Aswad. However, a study showed that trabeculectomy was less expensive overall than a PreserFlo microshunt (Glaukos) while yielding similar quality of life outcomes.
“If you look at the medication, the surgery, lasers, everything is more expensive when we wait for the patient to become severe,” Al-Aswad said. “That pushes us to want to diagnose glaucoma early to decrease the cost to health care, help patients and prevent blindness.”
Al-Aswad previewed a new online automated calculator designed to help ophthalmologists embrace more cost-effective treatment options.
“You can input different data points for minimally invasive glaucoma procedures and decide which one is more cost-effective to you vs. another one,” she said.
References:
- Atik A, et al. Ophthalmology. 2022;doi:10.1016/j.ophtha.2022.05.016.
- Sood S, et al. Ophthalmol Glaucoma. 2023;doi:10.1016/j.ogla.2022.10.005.
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Al-Aswad L. Cost-effectiveness of current approaches to glaucoma treatment. Presented at: American Glaucoma Society meeting; Feb. 26-March 2, 2025; Washington (hybrid).
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