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Burden of Disease and Healthcare Costs of Patients Treated with Antiglaucoma Drugs

      Objectives

      The aim of this study is the analysis of the healthcare pathways of patients treated with antiglaucoma drugs, assessing the healthcare and the economic burden of glaucoma through comorbidities, specific drug prescriptions, hospitalizations and specialist procedures patterns for 2013 and 2014.

      Methods

      From the ARCO database (about 17 million Italian citizens), a record linkage of free filled drug prescriptions, hospitalizations and specialist procedures data was performed and a cohort of patients treated with antiglaucoma drugs was selected (accrual period: 1 January – 31 December 2013) and followed-up over 12 months from the index date.

      Results

      From a population of 8,745,228 citizens, a cohort of 177,800 patients with Glaucoma (2.0%) was selected: mean age 71±13 years; 56% females. 22% of them have also Diabetes, 65.9% Hypertension, 9.6% Asthma/COPD and 23.4% are treated with betablockers. Antiglaucoma treatment increases with age for every comorbidity group. Antibacterials for systemic use (54.8%) and agents acting on renin-angiotensin system (53.6%) are the most prescribed during follow-up. Between antiglaucomas, timolol, combinations and plain, is the most prescribed (respectively 33.5% and 26%) with on average 12.4 and 9.9 packs per year, followed by Latanoprost (13.6%). Other specific drugs are prescribed to less than 3% of patients. Among fixed combinations, timolol and bimatoprost is the most prescribed. In all comorbidity groups no differences were found in antiglaucomas prescriptions. The average annual per capita cost of a patient with Glaucoma was 2,552€, particularly 816€ for drugs, 868€ for hospitalizations and 435€ for outpatient specialist/diagnostic procedures. Patients with Asthma/COPD are the most expensive (3,833€).

      Conclusions

      According to literature, Glaucoma is still highly underdiagnosed, increasing the burden on the NHS for the 50% of patients diagnosed too late. This study can help the health governance to improve clinical and economic decisions for a better disease management based on a patient centered view.