Glaucoma Treatment for Medicare Patients Inexpensive

Barbara Boughton

March 08, 2013

SAN FRANCISCO, California — Glaucoma is a sight-threatening condition, but it's relatively cheap to treat and to prevent progression to severe vision loss or blindness. In fact, treatment for glaucoma costs 67% less than healthcare for other eye conditions, such as cataracts and retinal diseases, according to a new study of the American Medicare population.

"This study provides a look at how much glaucoma treatment costs. As it turns out, it's not that expensive," said lead investigator Harry Quigley, MD, from the Wilmer Eye Institute in Baltimore, Maryland. He presented the research here at the American Glaucoma Society 23rd Annual Meeting.

Glaucoma treatment in the Medicare population costs a mean of $263 per person each year, according to Dr. Quigley. Most of that expense comes from office visits and diagnostic testing; laser procedures and surgery for glaucoma make up just 20% of treatment costs.

"Glaucoma specialists are not big players in terms of Medicare reimbursement," Dr. Quigley said. The total cost for glaucoma treatment in the Medicare budget is $1.4 billion per year, which is less than half of 1% of total Medicare reimbursements, he noted.

Dr. Quigley and colleagues used data from a 5% random sample of Medicare billing information from 2002, 2006, and 2009. They classified the healthcare claims from that sample into 3 categories: glaucoma treatment, therapies for other eye conditions, and other medical care.

Glaucoma specialists are not big players in terms of Medicare reimbursement.

From 2002 to 2009, the mean cost of glaucoma care rose 30%, from $197 to $263 per person per year, Dr. Quigley reported. The increase was due to increased reimbursements for office visits, a greater number of diagnostic assessments for open-angle glaucoma, and more laser and surgical procedures, according to Dr. Quigley.

He noted that in this sample, Medicare payments for glaucoma treatments increased less than the general rate of medical inflation from 2002 to 2009.

One limitation to this study is the fact that Medicare does not reimburse for glaucoma drops — the mainstay of treatment — so those costs were not included in the analysis.

"It's surprising that the cost of glaucoma care was so low," Joel Schuman, MD, from the University of Pittsburgh, Pennsylvania, told Medscape Medical News.

This study "gives us a thorough look at the cost of glaucoma eye care, and shows us that the healthcare we provide to our patients is relatively cost efficient," said Dr. Schuman, who cochaired the session at which the study was presented.

It also underscores the importance of giving glaucoma patients relatively inexpensive but cost-effective treatments, such as eye drops, early on, because progression can lead to more intensive and costly treatments or blindness, Dr. Schuman noted.

Dr. Quigley reports being a consultant for Merck, Genentech, GreyBug, Sensimed, and Sucampo. Dr. Schuman has disclosed no relevant financial relationships.

American Glaucoma Society (AGS) 23rd Annual Meeting: Abstract 17. Presented March 2, 2013.