Trends in medical and surgical treatments of glaucoma in Taiwan, 1997–2007

Poster Details

First Author: J.Lin TAIWAN

Co Author(s):    M. Lai              

Abstract Details

Purpose:

To analyze quantitative changes in glaucoma treatment strategies in Taiwan over an 11-year period (1997–2007), to critically comment on changes observed and to see whether the trends are consistent with clinical trial outcomes and published guidelines. To evaluate trends in costs based on the types of ocular hypotensive drug prescription and glaucoma surgical procedures being performed.

Setting:

Posters - Miscellaneous

Methods:

A retrospective, observational, population-based analysis was implemented using data from Taiwan’s National Health Insurance Research Database between January 1997 and December 2007. Patients who were 18 years or older and had at least an ocular hypotensive drug claim during the study period were identified. The trends of prescribing cost were described. The annual number of claims and payments for glaucoma surgical procedures were also calculated.

Results:

The cost of ocular hypotensive drug prescriptions raised 7.09 fold. The largest increase in prescribing cost was for prostaglandin analogue use. The prostaglandin analogue class was the second most frequently prescribed OHD class and its prescribing rate substantially increased since 2000. The prescribing cost of new classes of OHD, ?-agonist and fixed combination, also significantly increased within a short period of time. The ?-blocker class was the most commonly used OHD, but the prescribing cost for this class reached a plateau over time. A trend towards combination therapy was observed away from monotherapy. Trabeculectomies decreased 33.6% over the study period, although cyclocryotherapy procedures rose 60% over the study period. The number of aqueous shunting devices placed rose from 2004. However, the number of laser trabeculoplasties increased 73.3% over the study period. The number of laser iridotomies showed little fluctuation, increasing 24.3% over the study period. The cost of laser procedure increased 26.9% over the study period, although the cost of surgical procedures decreased 30.9% over the study period.

Conclusions:

Findings suggest that new glaucoma drugs, primarily prostaglandins, improved intraocular pressure control and delayed surgery. The overall number of glaucoma laser procedures is also increasing, payments have not been decreasing. These findings may imply that management of glaucoma patients in Taiwan had a positive trend towards recent clinical trial outcomes and guideline’s recommendation. FINANCIAL DISCLOSURE?: No