An observational, retrospective two-year cost study in primary open-angle glaucoma and ocular hypertension in newly diagnosed patients

Purpose: To investigate the different treatment strategies in France and th e direct costs for patients with newly diagnosed primary open-angle glaucom a or ocular hypertension who have started treatment with beta-blockers, and to estimate the total direct cost for two years of treat. Material and methods: We analyzed 225 medical charts retrospectiv in eleven academicly and office-based centers in France over the first two years aft er diagnosis. Standard costs for each resource in current medical practice were determined from the French Social Security perspective, Results: The vast majority of patients (90%) had a diagnosis of primary, op en-angle glaucoma or ocular hypertension in both eyes. In 60% of the patien ts we found a moderate or severe defect in their visual field or optic nerv e. Intraocular pressure before treatment was 23.9+4.7mmHg and 17.5+4.2mmHg after two years of treatment. Over the first two years, 25% of visits led t o a change in therapy (medical or surgical), involving 64% of the patients. Two-thirds of the changes occurred during the first year of treatment and in around 80% of cases for low intraocular pressure at check-up. Laser surg ery or surgical intervention was performed in 25% of the patients. Total di rect costs for two years were 5698F.F. The intraocular pressure before trea tment was positively correlated (p <0.01) with treatment costs, while the i nitial intraocular pressure-lowering effects of treatment were negatively c orrelated with two-year costs. Conclusion: after two years of treatment, the mean intraocular pressure dec reased from 24 to 17.5mmHg. The higher the basal intraocular pressures is, the more intensive the treatment and the higher the costs. The more efficie nt the treatment to decrease baseline intraocular pressure is, the earlier the costs will be reduced.