Medical Management of Glaucoma: Cost-Effectiveness

Glaucoma is a chronic disease requiring life-long management. Since the 1990s several new glaucoma medications are available as are refinements in laser and surgical treatments for glaucoma. In healthcare systems with finite budgets decisions have to be made to determine the best use of health resources in terms of treatment effectiveness and cost-effectiveness. The cost-effectiveness of alternative treatments should take into account both short- and long-term costs and benefits. There are wide variations in reported costs of glaucoma therapy across nations, but information from economic evaluations alongside randomized controlled treatment trials or model-based evaluations linking costs and benefits are sparse. There are few reports from low- and middle-income countries and data especially economic data from high-income countries may not be applicable. Cost-effectiveness decisions are country-specific because patterns of care (and hence resource use) as well as costs may vary. Furthermore, so might the value that patients place on the outcomes of treatment. Pricing of glaucoma medications is not transparent and prices change over time and between countries. Reductions in the costs of ocular hypotensive agents may alter cost-effectiveness conclusions. Generic treatments can reduce the costs of glaucoma therapy as long as delivery mechanism for the eye drop facilitates easy drop instillation by the patients. Adherence to medication is of extreme importance. No matter how efficacious a drug is if the patient does not adhere with the medication regimen then the treatment cannot be effective or cost-effective.