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Financial cost in developed countries

Glaucoma is an expensive disease to treat, and the recent economic downtown has rendered affordability of care in developed countries increasingly difficult.

According to Dr. Quigley, patients in many European countries benefit from national health care systems that help regulate the cost of treating the disease. However, for patients on multiple medications in the U.S., the out-of-pocket price of medical therapy can be substantial. A total of $2.86 billion is spent annually in the U.S. on glaucoma patients 40 years and older in direct medical costs, representing outpatient, inpatient and prescription drug costs, Rein and colleagues found.

Cost of care for glaucoma is also expensive, Dr. Quigley said. Office visits for glaucoma-related care are the third most frequent reason across all fields of medicine why patients see physicians in the U.S., behind visits for hypertension and diabetes care, he said.

“Since Medicare is now, partly, to some degree covering pharmaceuticals, the visit charge, surgery charges and pharmaceutical charges are huge ticket items under Medicare,” Dr. Quigley said. “I think it won’t take terribly long, if they actually do get serious about reforming health care, before the government in the U.S. looks at that issue and figures out a more efficient way to take care of glaucoma than we’re now doing.”

Nathan G. Congdon, MD, MPH, said other costs that can become expensive over time might be overlooked, including transportation for patients to go to office visits and diminished productivity caused by visual loss.

“There are … burdens of treatment, particularly in the United States and Europe and the developed countries, where the government does pay a substantial part of the treatment,” he said. “[Glaucoma is] one of the more common conditions that we treat among older people, not just the cost of medicines, but the cost of office visits, the cost of various tests that need to be done in order to treat the disease. Those are part of a substantial cost that adds up as well.”