A Comparison Of Resource Use And Costs Of Caring For Patients With Exfoliation Syndrome Glaucoma Versus Primary Open-Angle Glaucoma.

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 pre-existing disease. We compared ophthalmic resource utilization and costs over 2 years of follow-up for persons with newly-diagnosed and pre-existing XFG versus those with POAG.

MAIN OUTCOME MEASURES: Number of clinic visits, diagnostic procedures, medication fills, laser and incisional surgery, and mean eyecare 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=0.001), cataract surgery (34.9% vs. 19.0%; p<0.0001) and glaucoma surgery (28.7% vs. 19.7%, p=0.002). They also experienced 27% higher mean total eyecare costs ($3260 vs. $2562, p=0.0001) over 2 years of follow-up. Among 2745 enrollees (median age 80.5 years) with pre-existing XFG and 89036 persons (median age 79.5) with pre-existing POAG, persons with XFG had more office visits (mean 9.3 vs. 7.3; p<0.0001), perimetry (85.3% vs. 79.8%; p<0.0001), cataract surgery (23.4% vs. 12.3%; p<0.0001), laser trabeculoplasty (18.6% vs. 9.6%; p<0.0001), trabeculectomy (8.1 vs. 1.8%; p<0.0001) and experienced 37% higher total mean eyecare costs ($3764 vs. $2739; p<0.0001).

CONCLUSIONS: Healthcare resource utilization and costs are substantially higher for managing patients with XFG compared to POAG.