advertisement

---

1 General aspects (0)   1.1 Epidemiology (26)   1.2 Population genetics (0)   1.3 Pathogenesis (8)   1.4 Quality of life (10)   1.5 Glaucomas as cause of blindness (13)   1.6 Prevention and screening (7) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (4)   2.2 Cornea (30)   2.3 Sclera (8)   2.4 Anterior chamber angle (3)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (9)     2.5.2 Schlemms canal (0)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (2)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (2)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (3)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (1)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (5)   2.13 Retina and retinal nerve fibre layer (27)   2.14 Optic disc (27)   2.15 Optic nerve (0)   2.16 Chiasma and retrochiasmal central nervous system (6)   2.17 Stem cells (3)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (2)   3.4 Molecular genetics (2)     3.4.1 Linkage studies (5)     3.4.2 Gene studies (29)   3.5 Molecular biology incl. SiRNA (4)   3.6 Cellular biology (41)   3.7 Biochemistry (4)   3.8 Pharmacology (15)   3.9 Pathophysiology (10)   3.10 Immunobiology (5)   3.11 Pharmacogenetics (0)   3.12 Proteomics (1)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (1)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (1)     3.13.3 RGC Imaging (0)     3.13.4 Other (1)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (0)   5.1 Rodent (17)   5.2 Primates (7)   5.3 Other (19) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (0)     6.1.1 Devices, techniques (10)     6.1.2 Fluctuation, circadian rhythms (7)     6.1.3 Factors affecting IOP (23)   6.2 Tonography, aqueous flow measurement (see also 2.6) (2)   6.3 Biomicroscopy (slitlamp) (0)     6.3.1 Anterior segment (1)     6.3.2 Posterior segment (0)   6.4 Gonioscopy (2)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (1)     6.6.2 Automated (32)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (8)   6.7 Electro-ophthalmodiagnosis (7)   6.8 Photography (0)     6.8.1 Anterior segment (2)     6.8.2 Posterior segment (5)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (0)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (18)       6.9.1.2 Confocal Scanning Laser Polarimetry (3)     6.9.2 Optical coherence tomography (0)       6.9.2.1 Anterior (8)       6.9.2.2 Posterior (37)     6.9.5 Other (0)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (1)   6.11 Bloodflow measurements (27)   6.12 Ultrasonography and ultrasound biomicroscopy (7)   6.13 Provocative tests (3)   6.19 Telemedicine (0)   6.20 Progression (15)   6.30 Other (1) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (9)   8.2 Hypermetropia (1)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (1) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (7)     9.1.2 Juvenile glaucoma (19)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (8)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (4)     9.2.2 Other risk factors for glaucoma (8)     9.2.3 Open angle glaucoma with elevated IOP (5)     9.2.4 Normal pressure glaucoma (7)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (3)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (0)     9.3.3 Plateau iris syndrome (0)     9.3.4 Primary angle closure suspect (2)     9.3.5 Primary angle closure (5)     9.3.10 Other (0)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (9)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (1)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (1)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (1)       9.4.3.5 Other (2)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (22)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (1)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (8)       9.4.5.5 Other (4)     9.4.6 Glaucomas associated with inflammation, uveitis (4)     9.4.7 Glaucomas associated with ocular trauma (1)     9.4.8 Glaucomas associated with intraocular tumors (2)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (2)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (1)       9.4.11.2 Glaucomas in aphakia and pseudophakia (3)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (4)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (5)     9.4.15 Glaucoma in relation to systemic disease (31)     9.4.20 Other (3) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (8) 11 Medical treatment (0)   11.1 General management, indication (10)   11.2 Cholinergic drugs (2)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (5)     11.3.4 Betablocker (10)     11.3.5 Other (0)   11.4 Prostaglandins (20)   11.5 Carbonic anhydrase inhibitors (1)     11.5.1 Systemic (0)     11.5.2 Topical (6)   11.6 Osmotic treatment (0)   11.7 Treatment of bloodflow (0)   11.8 Neuroprotection (29)   11.9 Gene therapy (3)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (3)     11.13.3 Betablocker and brimonidine (3)     11.13.4 Betablocker and prostaglandin (6)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (18)   11.15 Other drugs in relation to glaucoma (16)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (23)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (6)   11.20 Other (0) 12 Surgical treatment (0)   12.1 General management, indication (9)   12.2 Laser iridotomy (3)   12.3 Laser iridoplasty (1)   12.4 Laser trabeculoplasty and other laser treatment of the angle (11)   12.7 Surgical iridectomy (2)   12.8 Filtering surgery (1)     12.8.1 Without tube implant (14)     12.8.2 With tube implant or other drainage devices (21)     12.8.3 Non-perforating (7)     12.8.4 Using laser (0)     12.8.5 Other (3)     12.8.10 Woundhealing antifibrosis (9)     12.8.11 Complications, endophthalmitis (3)   12.9 Trabeculotomy, goniotomy (2)   12.10 Cyclodestruction (3)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (5)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (1)   12.15 Capsulotomy (1)   12.16 Vitrectomy (0)   12.17 Anesthesia (4)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (4)     13.2.2 Visual field (0)       13.2.2.1 Progression (1)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (14) 15 Miscellaneous (32)

---

Abstract #46883 Published in IGR 13-3

Predictive factors of glaucoma treatment cost in Germany

Lorenz K; Wolfram C; Claus V; Plesnila-Frank C; Verboven Y; Pfeiffer N
Value in Health 2010; 13: 398-399

---

OBJECTIVES: To describe total costs and factors predicting cost in Germany for glaucoma disease states: ocular hypertension (OHT), and early (EARLY), moderate (MOD) and advanced (ADV) glaucoma. METHODS: A 5-year retrospective analysis collected health care utilization, clinical parameters, treatment(s) used and reasons for treatment change. Disease states defined by the European Glaucoma Society were applied. Costs for health care resources were based upon the German EBM/OPS code for ambulatory visits/procedures, diagnosis-related groups for hospital procedures and the Rote Liste for medication. Factors predicting cost were identified using stepwise backward multiple linear regression, entry criterion a = 0.2. RESULTS: A total of 154 patients (27 OHT, 43 EARLY, 35 MOD, 49 ADV) were enrolled from 15 centers across 5 German regions. Average age was 67 (plus or minus) 11 and 57% were female. Number of years since diagnosis was 9.0 (plus or minus) 5.7, 8.7 (plus or minus) 4.6, 8.7 (plus or minus) 4.1 and 13.2 (plus or minus) 8.3 years for OHT, EARLY, MOD and ADV, respectively. Total costs, for patients with OHT, EARLY, MOD or ADV, were (euro)226 (plus or minus) 117, (euro)423 (plus or minus) 647, (euro)493 (plus or minus) 385, and (euro)808 (plus or minus) 877, respectively. Most costs were due to medication ((euro)121 (plus or minus) 99, (euro)217 (plus or minus) 150, (euro)245 (plus or minus) 161, (euro)340 (plus or minus) 193) and hospital interventions ((euro)32 (plus or minus) 101, (euro)115 (plus or minus) 538, (euro)154 (plus or minus) 285, (euro)367 (plus or minus) 811). Other costs included consultations ((euro)54, (euro)63, (euro)64, (euro)58) and examinations ((euro)19, (euro)26, (euro)26, (euro)26). Factors predicting high cost (R2 = 0.6426) were the number of hospital interventions, treatment switches, disease state changes, current disease state and issues with ocular burning, stinging or aching affecting daily activities. For glaucoma patients having 0, 1, 2 or (greater-than or equal to)3 treatment switches this gave total costs of (euro)273 (plus or minus) 108, (euro)320 (plus or minus) 231, (euro)511 (plus or minus) 462 and (euro)932 (plus or minus) 950, respectively. Medication costs were (euro)177, (euro)187, (euro)268 and (euro)368, and interventional procedure costs were (euro)0, (euro)50, (euro)166 and (euro)478, respectively. CONCLUSIONS: Glaucoma treatments (medication and interventional procedures) are the key cost drivers in management of glaucoma in Germany. Avoiding treatment switches, disease progression and interventional procedures should have an impact on the cost of glaucoma care.

K. Lorenz. Universitatsmedizin Mainz, Mainz, Germany.

---

Classification:

14 Costing studies; pharmacoeconomics

---

• ← Previous
• Next →

---