Cost-related nonadherence with glaucoma medications in Ontario

Abstract

ObjectiveTo determine the proportion of glaucoma patients in Ontario aged 25–64 who lack insurance coverage for glaucoma medications and to assess the frequency of cost-related nonadherence to glaucoma medications. DesignCross-sectional study. ParticipantsGlaucoma patients on medication from 2 glaucoma clinics in Toronto, Ontario. Methods100 consecutive glaucoma patients aged 25–64 (not entitled to provincial drug benefit) and 100 consecutive glaucoma patients aged 65+ (entitled to provincial drug benefit), all on topical glaucoma therapy, completed a standardized questionnaire. Questions included insurance coverage for glaucoma medications, cost concerns when paying for glaucoma medications, cost-related nonadherence, and sociodemographics. Results25.8% of those aged 25–64 express concerns about the cost of their glaucoma medications compared to 7.1% of those aged 65+ (p < 0.001). Patients aged 25–64 were also significantly more likely to report at least one form of cost-related nonadherence (15.5% vs 2.0%, p = 0.001) and significantly more likely to report missing eye drops in a given week than patients aged 65+ (32.0% vs 16.7%, p = 0.01). 17% (95% confidence interval 11%–26%) of patients aged 25–64 self-reported having no insurance coverage for their glaucoma medications. Of those with coverage, the most common source of insurance was employer-sponsored (68.6%) with 44% requiring a copayment. The average copayment was $18 (range $2–$250) for those aged 25–64 compared with $5 in the 65+ group (range $0.62–$100). Conclusions17% of glaucoma patients aged 25–64 do not have coverage for their drops. One in four expressed concerns about the cost of their glaucoma medications, and 15.5% reported cost-related nonadherence.