Growing costs in glaucoma: update and its impact in public health

Abstract

Knowledge of real and up-to-date situation of costs related to glaucoma is very important to planning actions, which intend to reduce economic and societal impact of blindness in Brazil and in the world. The purpose of this article is to update the real situation of glaucoma related costs, focusing on public health point of view. Health expenditures have risen lately and a good plan must involve cost analysis, using real and up-to-date information. Glaucoma is the leading cause of irreversible blindness in the world, accounting for elevated costs, both direct (medical expenditures, hospital costs, medications, exams, equipments, etc) and indirect (non-working days, caregiver burden, rehabilitation, etc). Global economic impact of visual deficiency and blindness, in direct costs, is around $ 42 millions per year, with an estimate of $ 110 millions in the year 2020. If the analysis takes into account QALY (quality-adjusted life years), this impact could rise up to $ 16 billions per year, only in the United States. A significant part in direct costs in glaucoma is due to chronic use of medications. There is evidence that these costs are higher as the disease progresses, and in those cases where the diagnosis is done in advanced stages of the disease. Therefore, actions that identifies risk factors for glaucoma, and also promotes early diagnoses and effective treatment, should be preferred. Cost-effectiveness studies are important, because they identify which diagnostic or therapeutic procedures are more viable in public health.