TY - JOUR
T1 - A Comparison of Resource Use and Costs of Caring for Patients With Exfoliation Syndrome Glaucoma Versus Primary Open-Angle Glaucoma
AU - Rathi, Siddarth
AU - Andrews, Chris
AU - Greenfield, David S.
AU - Stein, Joshua D.
N1 - Funding Information:
Funding/Support: P30EY014801 University of Miami core grant , Miami, Florida, USA (D.S.G.); Research to Prevent Blindness unrestricted grant to the University of Miami and University of Michigan, New York, New York (D.S.G. + J.D.S.); an unrestricted grant from Mr. and Mrs. Thorne B. Donnelley, Chicago, Illinois, USA (D.S.G.); the Maltz Family Endowment for Glaucoma Research, Cleveland, Ohio, USA (D.S.G.); W.K. Kellogg Foundation, East Grand Rapids, Michigan, USA (J.D.S.); National Eye Institute R01 EY026641 , Bethesda, Maryland, USA (J.D.S.); American Glaucoma Society Mentoring for Physician-Scientists Award, San Francisco, California, USA (S.R.). Financial Disclosures: Siddarth Rathi serves as a consultant to Digisight Technologies (San Francisco, California, USA) and EyeNovia (New York, New York, USA). David S. Greenfield serves as a consultant to Aerie Pharmaceuticals (Bedminster, New Jersey, USA), Alcon (Fort Worth, Texas, USA), Allergan (Madison, New Jersey, USA), Bausch + Lomb (Bridgewater, New Jersey, USA), Quark Pharmaceuticals (Fremont, California, USA), and Glaukos (San Clemente, California, USA). The following authors have no financial disclosures: Chris Andrews and Joshua D. Stein. All authors attest that they meet the current ICMJE criteria for authorship.
PY - 2019/4
Y1 - 2019/4
N2 - Purpose: To characterize differences in resource utilization and cost of managing enrollees with exfoliation glaucoma (XFG) compared to primary open-angle glaucoma (POAG). Design: Retrospective utilization and cost comparison using Medicare claims data. Methods: We identified Medicare beneficiaries with XFG or POAG and ≥5 years of continuous enrollment from January 2008 to December 2014. We distinguished newly diagnosed cases from those with preexisting disease. We compared ophthalmic resource utilization and costs over 2 years of follow-up for persons with newly diagnosed and preexisting XFG vs those with POAG. Main outcome measures were number of clinic visits, diagnostic procedures, medication fills, laser and incisional surgery, and mean eye care costs per beneficiary. Results: Among 192 eligible enrollees (median age 77.6 years) with newly diagnosed XFG and 7339 enrollees (median age 77.3 years) with newly diagnosed POAG, those with XFG had more office visits (mean, 9.1 vs 7.9; P =.001), cataract surgery (34.9% vs 19.0%; P <.0001), and glaucoma surgery (28.7% vs 19.7%, P =.002). They also experienced 27% higher mean total eye care costs ($3260 vs $2562, P =.0001) over 2 years of follow-up. Among 2745 enrollees (median age 80.5 years) with preexisting XFG and 89 036 persons (median age 79.5) with preexisting POAG, persons with XFG had more office visits (mean 9.3 vs 7.3; P <.0001), perimetry (85.3% vs 79.8%; P <.0001), cataract surgery (23.4% vs 12.3%; P <.0001), laser trabeculoplasty (18.6% vs 9.6%; P <.0001), and trabeculectomy (8.1 vs 1.8%; P <.0001) and experienced 37% higher total mean eye care costs ($3764 vs $2739; P <.0001). Conclusions: Healthcare resource utilization and costs are substantially higher for managing patients with XFG compared to POAG.
AB - Purpose: To characterize differences in resource utilization and cost of managing enrollees with exfoliation glaucoma (XFG) compared to primary open-angle glaucoma (POAG). Design: Retrospective utilization and cost comparison using Medicare claims data. Methods: We identified Medicare beneficiaries with XFG or POAG and ≥5 years of continuous enrollment from January 2008 to December 2014. We distinguished newly diagnosed cases from those with preexisting disease. We compared ophthalmic resource utilization and costs over 2 years of follow-up for persons with newly diagnosed and preexisting XFG vs those with POAG. Main outcome measures were number of clinic visits, diagnostic procedures, medication fills, laser and incisional surgery, and mean eye care costs per beneficiary. Results: Among 192 eligible enrollees (median age 77.6 years) with newly diagnosed XFG and 7339 enrollees (median age 77.3 years) with newly diagnosed POAG, those with XFG had more office visits (mean, 9.1 vs 7.9; P =.001), cataract surgery (34.9% vs 19.0%; P <.0001), and glaucoma surgery (28.7% vs 19.7%, P =.002). They also experienced 27% higher mean total eye care costs ($3260 vs $2562, P =.0001) over 2 years of follow-up. Among 2745 enrollees (median age 80.5 years) with preexisting XFG and 89 036 persons (median age 79.5) with preexisting POAG, persons with XFG had more office visits (mean 9.3 vs 7.3; P <.0001), perimetry (85.3% vs 79.8%; P <.0001), cataract surgery (23.4% vs 12.3%; P <.0001), laser trabeculoplasty (18.6% vs 9.6%; P <.0001), and trabeculectomy (8.1 vs 1.8%; P <.0001) and experienced 37% higher total mean eye care costs ($3764 vs $2739; P <.0001). Conclusions: Healthcare resource utilization and costs are substantially higher for managing patients with XFG compared to POAG.
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U2 - 10.1016/j.ajo.2018.12.024
DO - 10.1016/j.ajo.2018.12.024
M3 - Article
C2 - 30629910
AN - SCOPUS:85061137962
VL - 200
SP - 100
EP - 109
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -