The economic burden of medical management of glaucoma in South Western Nigeria: the patient's perspective

Glaucoma is the second most common cause of blindness worldwide; it is especially common in sub Saharan Africa where it poses serious long-term health and economic concerns. To evaluate from the patient's perspective, the economic cost of receiving care for primary open angle glaucoma in the outpatient eye clinic of a tertiary hospital, south western part of Nigeria. Consecutive consenting adult patients attending the outpatient eye clinic of the hospital being managed for primary open angle glaucoma with medical therapy only, were retrospectively recruited into the study. Information was obtained from the clinical records and with the aid of a semi-structured questionnaire. A total of 53 patients were enrolled into the study with mean age of 65.3 ± 11.6 years. Majority were retirees (34%), traders (30%) and civil servants (21%). The average direct medical cost per annum was N65,342.26 ± 54,866.92(US$209.10 ± 175.57) and average quantifiable indirect cost per annum was N17,799.47 ± 34977.25 (US$56.96 ± 111.93). Majority (62.3%) were solely responsible for funding the cost incurred while only 13% of patients had health insurance coverage. There was no significant difference in the costs incurred by insured and uninsured patients except for user fee. Out-of-pocket expenses for the medical management of primary open glaucoma was mainly incurred on direct medical cost. Health insurance coverage did not significantly reduce the financial burden on patients