Abstract
Objective
To determine the proportion of glaucoma patients in Ontario aged 25–64 who lack insurance
coverage for glaucoma medications and to assess the frequency of cost-related nonadherence
to glaucoma medications.
Design
Cross-sectional study.
Participants
Glaucoma patients on medication from 2 glaucoma clinics in Toronto, Ontario.
Methods
100 consecutive glaucoma patients aged 25–64 (not entitled to provincial drug benefit)
and 100 consecutive glaucoma patients aged 65+ (entitled to provincial drug benefit),
all on topical glaucoma therapy, completed a standardized questionnaire. Questions
included insurance coverage for glaucoma medications, cost concerns when paying for
glaucoma medications, cost-related nonadherence, and sociodemographics.
Results
25.8% of those aged 25–64 express concerns about the cost of their glaucoma medications
compared to 7.1% of those aged 65+ (p < 0.001). Patients aged 25–64 were also significantly more likely to report at least
one form of cost-related nonadherence (15.5% vs 2.0%, p = 0.001) and significantly more likely to report missing eye drops in a given week
than patients aged 65+ (32.0% vs 16.7%, p = 0.01). 17% (95% confidence interval 11%–26%) of patients aged 25–64 self-reported
having no insurance coverage for their glaucoma medications. Of those with coverage,
the most common source of insurance was employer-sponsored (68.6%) with 44% requiring
a copayment. The average copayment was $18 (range $2–$250) for those aged 25–64 compared
with $5 in the 65+ group (range $0.62–$100).
Conclusions
17% of glaucoma patients aged 25–64 do not have coverage for their drops. One in four
expressed concerns about the cost of their glaucoma medications, and 15.5% reported
cost-related nonadherence.
Objectif
Déterminer la proportion de patients âgés de 25 à 64 ans qui présentent un glaucome
et qui ne bénéficient d'aucune couverture d'assurance pour leurs médicaments antiglaucomateux
en Ontario, et évaluer la fréquence du non-respect du traitement antiglaucomateux
en raison du coût de ce dernier.
Nature
Étude transversale.
Participants
Patients sous médicaments antiglaucomateux issus de 2 cliniques de traitement du glaucome
à Toronto, en Ontario.
Méthodes
Cent patients consécutifs qui présentaient un glaucome et qui étaient âgés entre 25
et 64 ans (qui ne sont donc pas admis au régime provincial d'assurance-médicaments)
et 100 patients consécutifs qui présentaient un glaucome et qui étaient âgés de 65
ans et plus (qui sont donc admis au régime provincial d'assurance-médicaments) ont
répondu à un questionnaire standardisé. Les 200 sujets recevaient des collyres antiglaucomateux.
Les questions portaient sur la couverture d'assurance pour les médicaments antiglaucomateux,
les inquiétudes quant au paiement de tels médicaments, le non-respect du traitement
en raison du coût et les paramètres sociodémographiques.
Résultats
Quelque 25,8 % des sujets âgés entre 25 et 64 ans ont signalé avoir des inquiétudes
quant au coût de leurs médicaments antiglaucomateux, comparativement à 7,1 % des sujets
âgés de 65 ans et plus (p < 0,001). De même, les patients âgés entre 25 et 64 ans étaient significativement
plus susceptibles de signaler au moins une forme de non-respect du traitement en raison
de son coût (15,5 % vs 2,0 %; p = 0,001), et significativement plus susceptibles de signaler avoir manqué des doses
de leurs collyres pendant une semaine donnée, comparativement aux patients âgés de
65 ans et plus (32,0 % vs 16,7 %; p = 0,01). Par ailleurs, 17 % (intervalle de confiance à 95 % : 11 %–26 %) des patients
âgés entre 25 et 64 ans ont signalé n'avoir aucune assurance pour leurs médicaments
antiglaucomateux. Pour ce qui est des patients qui bénéficiaient d'une couverture
d'assurance, la source la plus fréquente de l'assurance était celle de l'employeur
(68,6 %), qui exigeait une quote-part dans 44 % des cas. La quote-part moyenne s’élevait
à 18 $ (fourchette : 2 $ à 250 $) pour les patients âgés entre 25 et 64 ans et de
5 $ (fourchette : 0,62 $ à 100 $) pour les âgés de 65 ans et plus.
Conclusions
Ainsi, 17 % des patients qui présentent un glaucome et qui sont âgés entre 25 et 64
ans ne bénéficient d'aucune couverture d'assurance pour leurs collyres. Un patient
sur 4 a exprimé une inquiétude quant au coût de ses médicaments antiglaucomateux,
et 15,5 % des sujets ont signalé ne pas toujours observer leur traitement médicamenteux
en raison de son coût.
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Article info
Publication history
Published online: February 03, 2021
Accepted:
January 9,
2021
Received in revised form:
November 16,
2020
Received:
August 10,
2020
Footnotes
Presented at the 2019 Association for Research in Vision and Ophthalmology and the 2019 Canadian Ophthalmological Society Annual Meeting.
Identification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
