Lazcano-Gomez Gabriel, Ramos-Cadena María de Los Angeles, Torres-Tamayo Margarita, Hernandez de Oteyza Alejandra, Turati-Acosta Mauricio, Jimenez-Román Jesús
Glaucoma Department, Asociación para Evitar la Ceguera en México Endocrinology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico.
Medicine (Baltimore). 2016 Nov;95(47):e5341. doi: 10.1097/MD.0000000000005341.
The aim of the study was to disclose a realistic estimate of primary open-angle glaucoma treatment, follow-up costs, and patients' monthly glaucoma-economic burden in an ophthalmology hospital in Mexico City.Prospective survey of 462 primary open-angle glaucoma patients from 2007 to 2012 was carried out. Costs from visits, glaucoma follow-up studies, laser, and glaucoma surgical procedures were obtained from hospital pricings. Education, employment, and monthly income were interrogated. Total cost was divided into hypotensive treatment cost, nonpharmacologic treatment cost (laser and surgeries), and follow-up studies and consults. Average wholesale price for drugs analyzed was obtained from IMS Health data; monthly cost was calculated using: Monthly cost = ([average wholesale price/number of drops per eye dropper] × number of daily applications) × 30 days.Patients were classified according to their glaucoma severity, and data were analyzed based on monthly income (average annual exchange rate: 12.85 Mexican pesos = 1 USD).The mean age was 70 ± 10 years, women = 81%, elementary school = 39%, and unemployed = 53%. Low-income group = 266 patients (57%), 146 with mild glaucoma; moderate-income group = 176 patients (38%), 81 with mild glaucoma; high-income group = 20 patients (4.3%), 10 with mild glaucoma. Patients' monthly average economic burden in glaucoma treatment: low-income patients = 61.5%, moderate-income patients = 19.5%, and high-income patients = 7.9%.Glaucoma-economic burden is substantial not only for health systems, but for the family and the patient. Therefore, screening plans for earlier diagnosis, and health policies that lessen the cost of disease management and increase adherence to treatment, and reduce the prevalence of blindness attributed to glaucoma are essential. These would improve quality of life, reduce personal and national expenditure, and help increase national economy.
本研究的目的是揭示墨西哥城一家眼科医院原发性开角型青光眼的实际治疗费用、随访成本以及患者每月的青光眼经济负担。对2007年至2012年期间的462例原发性开角型青光眼患者进行了前瞻性调查。从医院定价中获取就诊、青光眼随访研究、激光治疗和青光眼手术的费用。询问了患者的教育程度、就业情况和月收入。总成本分为降压治疗成本、非药物治疗成本（激光治疗和手术）以及随访研究和咨询成本。分析的药物平均批发价格来自艾美仕市场研究公司的数据；月成本使用以下公式计算：月成本 = （[平均批发价格/每滴管滴眼数]×每日滴眼次数）×30天。根据青光眼严重程度对患者进行分类，并根据月收入（年均汇率：12.85墨西哥比索 = 1美元）分析数据。平均年龄为70±10岁，女性占81%，小学学历占39%，失业者占53%。低收入组有266例患者（57%），其中146例患有轻度青光眼；中等收入组有176例患者（38%），其中81例患有轻度青光眼；高收入组有20例患者（4.3%），其中10例患有轻度青光眼。青光眼治疗中患者每月的平均经济负担：低收入患者为61.5%，中等收入患者为19.5%，高收入患者为7.9%。青光眼经济负担不仅对卫生系统，而且对家庭和患者来说都很沉重。因此，早期诊断的筛查计划以及降低疾病管理成本、提高治疗依从性并减少青光眼所致失明患病率的卫生政策至关重要。这些政策将改善生活质量，减少个人和国家支出，并有助于促进国家经济增长。
