Costs and utilization of end-stage glaucoma patients receiving visual rehabilitation care: A U.S. multi-site retrospective study

The purpose of this retrospective chart review is to assess real-world ophthalmologic management and use of visual rehabilitation care (VRC) services in patients with end-stage glaucoma, including both direct and indirect costs of these resources. A random sample of 81 primary open-angle glaucoma (POAG) patient charts was selected and reviewed from three VRC facilities across the U.S. for 1998 to 2004. Two years of patient-level clinical and economic data were collected for ophthalmic and VRC visits. The mean number of visits per patient in the first year (both VRC and ophthalmology) was 7.1, compared with 5.4 annually during the 2-year period. Total cost per patient in the first year was greater than in the second year ($2170 vs. $1202, respectively). VRC-related costs were also greater in the first year than the second year ($365 vs. $126, respectively). Ophthalmology costs were also higher in the first year compared with the second year ($920 vs. $332 per patient, respectively), but pharmacy costs remained essentially constant from first year to second year ($885 vs. $744 per patient, respectively). POAG has a high direct healthcare cost in its advanced stages, highlighting the importance of early treatments in order to slow disease progression.