Abstract:
Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable
cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of
management, especially in developing countries. This study determined the cost of the medical management of
POAG, adherence, and pattern of medication prescription in Ghana.
Methods: A retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) cases seen
in the year 2012 at three referral facilities. Demographics, ocular history, resource consumption, medication, test,
surgery and other related cost were extracted from 84 patients who had fully complied with their treatment to
calculate total cost (TC) based on 2012 estimates. Glaucoma drugs prescribed to patients who had adhered to all
their review visits within the period evident from case folders were recorded and analysed for the prescription
pattern.
Results: Out of 891 POAG cases seen in 2012, 351(39.4 %) attended all the required review visits, but only 84 (9.4)
had fully and continually adhered to all their treatment regimes. They comprised 41(48.8 %) males and 43(51.2 %)
females with a mean age of 65 ± 14.8. Majority of the respondents were elderly above 60 year of age (65.5 %). The
total estimated cost for the 84 cases in the year was GH¢ 81,237 ($40,619), comprising GH¢ 72,193 ($36,097) direct
medication cost and GH¢9,045 ($4,523) direct non-medication cost (surgery and test cost), and an average of GH¢
967 ($484) for a mean visit of 5.6 ± 1.1 in the year. A total of 673 glaucoma medications had been prescribed for
351 patients for the year, with timolol being the most prescribed (64.19 %) and monotherapy as the most adopted
form of therapy (61.06 %). Age and income showed concurrent increase with cost (P ≤ 0.05).
Conclusions: Cost of managing glaucoma constitutes a substantial financial burden and influenced the pattern of
medication prescription.
