What is the direct cost of treatment of acute primary angle closure glaucoma? The Singapore model

Abstract

Aim: To estimate the cost of management of acute primary angle closure glaucoma in Singapore. Methods: In this cost analysis using retrospective data, the authors performed a MEDLINE search of published papers on acute primary angle closure glaucoma (APACG) in Singapore. Using information from published data, clinical management pathways were constructed and clinical out-comes identified. For each management path, costs of medical treatment, hospitalization, clinic charges, investigations, laser treatment and surgery were identified and accounted over a 5-year treatment period, using year 2002 rates. Results: Given that, in Singapore, APACG affects 12.2 per 100 000 per year (95% confidence interval [CI], 10.5-13.9) in those aged 30 and older, each annual cohort would need to pay US$261 741.78 (95%CI: US$225 310.90-298 265.10) or US$287 560.26 (95%CI: US$247 274.04-330 624.84), if inclusive of cataract surgery, over 5 years after the episode of APACG. In this period, individuals would have to commit between US$879.45 and US$2576.39, depending on the complexity of disease and accompanying cataract surgery. Conclusion: Acute primary angle closure glaucoma produces a substantial financial burden on society as well as on the individual.