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Practice patterns and costs of glaucoma treatment in Japan

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Abstract

Purpose

Understanding the practice patterns and costs of glaucoma care in real-world clinical settings is important for optimizing medical expenses. However, glaucoma treatment trends and associated costs in Japan are unknown. We aimed to unveil glaucoma treatment trends and costs using a large administrative claims database in Japan.

Study design

Retrospective cohort study.

Methods

We included patients diagnosed with glaucoma between April 2014 and March 2021 using the DeSC database. We calculated the frequencies and costs of antiglaucoma eyedrops, incisional or laser procedures, and ophthalmic examinations stratified by fiscal year and age. In the year-by-year analyses, the age distribution was standardized based on the 2020 distribution.

Results

A total of 841,747 patient-years (429,051 patients) were included. The number of prescribed eyedrops significantly increased and the fixed-combination eyedrops proportion decreased with age. Trabeculectomy frequency decreased, and that of laser trabeculoplasty increased during the observation period. The frequencies of both incisional and laser procedures peaked in the 75–79 age group. In 2020, 16.1 bottles of eyedrops per patient-year were prescribed, and 15.9 incisional surgeries and 11.3 laser therapies were performed per 1000 patient-years. Intraocular pressure measurement and visual field testing were performed 6.5 times and 2.0 times per patient-year, respectively. The total direct cost of glaucoma treatment was 55,139 yen (US $399.5) per patient-year, of which medications accounted for 44.2%, ophthalmic examinations for 47.4%, and incisional or laser procedures for 8.4%.

Conclusion

These results may be useful for understanding glaucoma treatment trends and costs in Japan.

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Acknowledgements

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (21AA2007) and the Ministry of Education, Culture, Sports, Science, and Technology, Japan (20H03907), The Health Care Science Institute Research Grant, and The Institute for Health Economics and Policy.

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Authors and Affiliations

  1. Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan

    Asahi Fujita, Yohei Hashimoto, Hiroki Matsui & Hideo Yasunaga

  2. Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Asahi Fujita, Yohei Hashimoto & Makoto Aihara

  3. Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Akira Okada

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  1. Asahi Fujita
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Correspondence to Asahi Fujita.

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A. Fujita, None; Y. Hashimoto, None; A. Okada, None; H. Matsui, None; H. Yasunaga, None; M. Aihara, None.

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Corresponding Author: Asahi Fujita

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Fujita, A., Hashimoto, Y., Okada, A. et al. Practice patterns and costs of glaucoma treatment in Japan. Jpn J Ophthalmol 67, 590–601 (2023). https://doi.org/10.1007/s10384-023-01002-w

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