Direct Costs of Blindness Experienced by Patients Enrolled in Managed Care

Purpose To evaluate total and condition-related charges incurred by blind patients in a managed care population in the United States and compare total charges with those of a matched nonblind cohort. Design Retrospective cohort study. Participants Patients with blindness (N = 10 796) and a 1:1 matched cohort of nonblind patients were selected from a managed care claims database. All study subjects were required to be ≥18 years old at diagnosis (blind patients) or enrollment (nonblind patients) and to have had ≥1 years of continuous follow-up. Methods Total and pharmacy-related direct medical charges in the first year of follow-up were calculated for both blind and nonblind cohorts. Among blind patients, condition-related charges, charge per treated person, and charge breakdown by age group were calculated. For patients with follow-up extending past 1 year, total charges (both cohorts) and condition-related charges (blind cohort only) were assessed and annualized. Mean and median charges were assessed for blind and nonblind patients within each stratum of matched covariates; a multivariate linear regression assessed the statistical significance of the difference in charges between the 2 cohorts. Main Outcome Measures Total health care charges in the first year of follow-up and condition-related health care charges in the first year of follow-up for blind patients. Results For the blind population (mean age, 52 years [standard deviation (SD), 17.5]), the total mean and median health care charges per person in the first year were $20 677 (SD, $48 835) and $6854, respectively. Total mean and median health care charges per nonblind patient in the first year were $13 321 (SD, $40 059) and $3778, respectively. Condition-related charges among blind patients were substantially lower than total charges, with mean and median charges per person of $4565 (SD, $17 472) and $371, respectively. After adjusting for covariates, blind patients had significantly higher total health care charges in the first year of follow-up than nonblind patients ( P