Abstract
ObjectivesTo estimate the cost and patterns of expenditure of dry eye treatment.MethodologyWe retrieved data on the type and cost of dry eye treatment in Singapore National Eye Centre from pharmacy and clinic inventory databases over a 2 year period (2008–2009) retrospectively. According to the type of treatment, data were sorted into 7 groups; meibomien gland disease (MGD) treatment, preservative free lubricant eye drops, preserved lubricant eye drops, lubricant ointments and gels, cyclosporine eye drops, oral supplements and non-pharmacological treatments/procedures. Each recorded entry was considered as one patient episode (PE). Comparisons in each group between two years were carried out using Pearson Chi-Square test. Significance level was set at alpha = 0.05.ResultsCost data from 54,052 patients were available for analysis. Total number of recorded PEs was 132,758. Total annual expenditure on dry eye treatment for year 2008 and 2009 were US$1,509,372.20 and US$1,520,797.80 respectively. Total expenditure per PE in year 2008 and 2009 were US$22.11 and US$23.59 respectively. From 2008 to 2009, there was a 0.8% increase in total annual expenditure and 6.69% increase in expenditure per PE. Pharmacological treatment attributes to 99.2% of the total expenditure with lubricants accounting for 79.3% of the total pharmacological treatment expenditure. Total number of units purchased in preservative free lubricants, cyclosporine eye drops and MGD therapy have increased significantly (p<0.001) whereas number of units purchased in preserved lubricants and ointments/gels have reduced significantly (p<0.001) from 2008 to 2009.ConclusionDry Eye imposes a significant direct burden to health care expenditure even without considering indirect costs. Health care planners should be aware that these direct costs appear to increase over the time and more so for particular types of medications. Given the limitations of socio-economic data, true societal costs of Dry eye syndrome are likely to be much higher than estimated.
Highlights
Dry eye syndrome (DES) is a multifactorial chronic disease that affects millions of people over the world with significant socioeconomic implications, including expenses associated with increased health care utilization and impact on daily social and physical functioning, work place productivity and quality-of-life [1,2,3,4]
According to the type of treatment, data were sorted into 7 groups; Group A: Treatment for meibomian gland disease (MGD), Group B: Preservative free lubricant eye drops, Group C: preserved lubricant eye drops, Group D: lubricant ointments and gels, Group E: Cyclosporine eye drops, Group F: Oral supplements Group G: Non pharmacological treatments/procedures
There was only 0.8% increase in total annual expenditure from 2008 to 2009
Summary
Dry eye syndrome (DES) is a multifactorial chronic disease that affects millions of people over the world with significant socioeconomic implications, including expenses associated with increased health care utilization (e.g. medication and physician visits) and impact on daily social and physical functioning, work place productivity and quality-of-life [1,2,3,4].Traditional treatment for DES has been largely palliative with over the counter lubricating eye drops or artificial tears. Dry eye syndrome (DES) is a multifactorial chronic disease that affects millions of people over the world with significant socioeconomic implications, including expenses associated with increased health care utilization (e.g. medication and physician visits) and impact on daily social and physical functioning, work place productivity and quality-of-life [1,2,3,4]. Evaluating cost effectiveness of dry eye treatment is quite challenging due to the multifactorial nature of the disease and potential limitations of techniques available to evaluate therapeutic outcomes of multi-palliative treatment modalities used. In US cost of managing dry eye patients in health care organizations is estimated at US$700,000 per million patients [8]. There are large variations in the dry eye treatment costs between countries in Europe [9]. The absolute costs may be much higher for the Asian population as the prevalence rates of dry eye in Asian population is higher (30%) compared to predominant Caucasian populations (15%) [8]
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