PSS3 Medical Resource Use and Associated Costs in Open-Angle Glaucoma in 10 Asia-Pacific Countries

Abstract

More than 40% of worldwide open-angle glaucoma (OAG) cases occur in Asia. The OAG prevalence and associated economic burden are expected to rise further. We extrapolated the findings from a German patient chart review in ocular hypertension (OHT) and OAG to 10 Asia-Pacific countries using expert interviews, in order to estimate the country specific OAG management costs. Two to 5 key opinion leaders per country were asked to review a list of medical resources used in OHT/OAG (ophthalmologist visits, examinations/tests, outpatient or inpatient surgery/laser, eye drops) collected during the retrospective COGIS study in 159 German OHT/OAG patients, and approve the type and frequency of the resources or modify them to represent their local practice. The amount of resources used was presented by disease stage (OHT, early, moderate, advanced OAG) and number of treatment changes (no change, 1, 2, ≥3 changes) as the COGIS study demonstrated an increased intensity of resource use depending on both parameters. Local unit costs were collected and applied to each item to estimate the management costs (All-payer perspective, 2011 costs). Thirty ophthalmologists validated the data (Australia 2 experts, China 4, Hong Kong 3, India 5, Malaysia 3, New Zealand 3, South Korea 2, Singapore 2, Taiwan 2, Thailand 2). The increasing frequency of resources used with increasing disease severity and number of switches was generally approved. The average annual cost per patient ranged from 186US$ to 1689US$, mainly driven by topical medications, examinations/tests and clinical practice patterns. The interviews allowed to extrapolate European findings to the Asia-Pacific region and therefore improved the validity of the cost-effectiveness models developed for these countries. In our opinion, this methodology represents an acceptable alternative when more time-consuming and costly chart reviews cannot be repeated in multiple countries. The significant economic burden of OAG was confirmed.