Zhao PY, et al. - Experts compared the prices of topical glaucoma medications, laser trabeculoplasty, and trabeculectomy relative with median annual household income (MA-HHI) for countries worldwide. The costs of medical, laser, and incisional surgical interventions, for many patients worldwide, were 2.5% or more of the MA-HHI. Addressing multiple contributing factors, including making glaucoma interventions more affordable were required in successfully reducing global blindness from glaucoma.

Methods

• Authors conducted a cross-sectional observational study.
• They obtained, for each country, prices for glaucoma medications, laser trabeculoplasty, and trabeculectomy using government pricing data, drug databases, physician fee schedules, academic publications, and communications with local ophthalmologists.
• They adjusted the prices for purchasing power parity and inflation to 2016 US dollars, and annual therapy prices were assessed relative to the MA-HHI.
• Experts considered the interventions costing less than 2.5% of the MA-HHI as affordable.
• Daily cost for topical glaucoma medications, cost of annual therapy with glaucoma medications, laser trabeculoplasty, and trabeculectomy relative to MA-HHI in each country were included in the main outcomes and measures.

Results

• As per the findings, data were obtained from 38 countries, including 17 developed countries and 21 developing countries, as classified by the World Economic Outlook.
• In intervention prices, considerable variability was observed compared with MA-HHI across the countries and across interventions, ranging from 0.1% to 5% of MA-HHI for timolol, 0.1% to 27% for latanoprost, 0.2% to 17% for laser trabeculoplasty, and 0.3% to 42% for trabeculectomy.
• In all countries studied, timolol was the most affordable medication and was 2.5% or more of MA-HHI in only 2 countries (5%).
• Findings suggested that in 15 countries the annual cost of latanoprost was 2.5% or more of MA-HHI (41%) (15 developing countries [75%] and no developed countries).
• In 15 countries (44%) (11 developing countries [65%] and 4 developed countries [24%]), the cost of laser trabeculoplasty was 2.5% or more of the MA-HHI.
• Authors noted that in 28 countries (78%) (18 developing countries [95%] and 10 developed countries [59%]), the cost of trabeculectomy was 2.5% or more of the MA-HHI.
• Laser trabeculoplasty cost less than a 3-year latanoprost supply in 18 countries (53%).