Economic cost of management of glaucoma in public and private health facilities in the Tema metropolis in Ghana

Abstract

Objectives: This study sought to determine the economic cost of the management of glaucoma among patients seeking care in health facilities in Ghana.
Design: A cross-sectional cost-of-illness (COI) study from the perspective of the patients was employed.
Setting: The study was conducted in public and private eye care facilities in the Tema Metropolis of Ghana.
Participants: About 180 randomly selected glaucoma patients seeking healthcare at two facilities participated in the study.
Main outcome measure: Direct cost, including medical and non-medical costs, indirect cost, and intangible burden of management of glaucoma.
Results: the cost per patient treated for glaucoma in both facilities was US$60.78 (95% CI: 18.66-107.80), with the cost in the public facilities being slightly higher (US$62.50) than the private facility (US$ 59.3). The largest cost burden in both facilities was from direct cost, which constituted about 94% of the overall cost. Medicines (42%) and laboratory and diagnostics (26%) were the major drivers of the direct cost. The overall cost within the study population was US$10,252.06. Patients paid out of pocket for the frequently used drug- Timolol, although expected to be covered under the National Health Insurance Scheme (NHIS). Patients, however, expressed moderate intangible burdens due to glaucoma.
Conclusion: The cost of the management of glaucoma is high from the perspective of patients. The direct costs were high, with the main cost drivers being medicines, laboratory and diagnostics. It is recommended that the National Health Insurance Authority (NHIA) should consider payment for commonly used medications to minimize the burden on patients.