To provide updated estimates of the clinical and economic burden in patients with ocular hypertension (OHT) or open-angle glaucoma (OAG) by disease severity in United States patients and estimate incremental costs associated with disease progression.
Retrospective cohort study.
Patients with ≥1 International Classification of Diseases, 10 Revision Clinical Modification diagnosis for OAG/OHT aged ≥40 years.
Patients were identified from IQVIA’s PharMetrics® Plus database during the index period (10/1/2015-8/31/2017). Patients had continuous health plan enrollment for ≥12 months before and after index date (first OAG/OHT diagnosis during index period) and were stratified by baseline disease severity based on diagnosis code. Annual eye-related outpatient healthcare utilization and costs were estimated on a per user basis. A generalized linear model was used to estimate adjusted mean costs by severity and evaluate the impact of observed disease worsening on costs. A multivariable logistic regression evaluated the relationship between severity and odds of falls/fractures.
Total eye-related outpatient costs and odds of falls/fractures.
177,352 OHT/OAG patients were identified (67.8% OAG). OAG patients had higher eye-related outpatient costs than OHT patients (median [interquartile range (IQR)]: $516 [$323-$898] vs. $344 [$197-$617], respectively). Patients with severe OAG had higher eye-related outpatient costs than moderate and mild OAG patients (median [IQR]: $639 [$381-$1,264] vs. $546 [$345-$950] vs. $476 [$304-$765], respectively; p<0.0001), as well as higher glaucoma-related pharmacy costs (median [IQR]: $493 [$122-$1,457] vs. $244 [$84-$1,113] vs. $139 [$66-$818], respectively; p<0.0001). In adjusted analyses, disease worsening was associated with at least two-fold higher annual eye-related outpatient costs (p<0.0001). Severe OAG patients had significantly higher odds of fall/fracture compared to OHT patients (Odds Ratio=1.34, 95% Confidence Interval: 1.13, 1.59).
Updated estimates show highest eye-related costs for those with severe disease and disease progression, among patients with OAG/OHT. Severe OAG was associated with increased risk of falls/fractures compared to patients with OHT. Therapies that delay disease progression may provide clinical and economic benefits.

Copyright © 2020. Published by Elsevier Inc.