Prevalence, Incidence, and Treatment Characteristics of Primary Open-Angle Glaucoma Among Medicare Fee-for-Service Beneficiaries.

Abstract

Purpose: This study aimed to describe Medicare FFS beneficiaries with prevalent and incident POAG, and to determine their demographic characteristics. Secondary objectives included describing POAG prescription rates, prescribers of POAG therapy, and dry eye disease rates among POAG prevalent beneficiaries.

Patients and methods: The study was a retrospective cohort analysis using de-identified Medicare FFS medical and pharmacy claims and enrollment data (Parts A/B/D) spanning from January 1, 2016, to December 31, 2021. Medicare FFS beneficiaries were included in the analysis if they were diagnosed or treated for POAG, 65 years of age or older, and continuously enrolled for at least 24 months. Beneficiaries were identified between January 1, 2017, and December 31, 2021, allowing for a 12-month baseline to categorize patients as incident or prevalent. Comorbid dry eye disease and prescription POAG therapies were also identified. Prescriber NPIs were used to classify prescriber types.

Results: From 2017 to 2021, 5.5-6.2% of Medicare FFS beneficiaries were identified with prevalent POAG, with ~1% categorized as incident. A higher proportion of POAG beneficiaries were older and/or Black. At least 81% received POAG prescription therapy each year, with ophthalmologists as most frequent prescribers. Comorbid dry eye was documented in 16.4-18.7% of beneficiaries with prevalent POAG, and in 11.8-13.6% of beneficiaries with incident POAG.

Conclusion: A significant proportion of Medicare FFS beneficiaries have POAG. While most people with POAG received some type of prescription therapy each year, a notable proportion of individuals had no form of prescription POAG therapy identified. Given higher rates of dry eye disease in people with glaucoma, dry eye disease screening and care among beneficiaries with POAG should be promoted. Future research should evaluate treatment patterns and outcomes among Medicare FFS beneficiaries with comorbid POAG and dry eye disease.