Introduction: Glaucoma is a serious chronic condition that affects the optic nerve due to the persistent elevated intraocular pressure. Worldwide, it is the number one cause of irreversible vision loss and the second leading cause of blindness. By 2020, more than 80 million are expected to have glaucoma because of population aging and the presence of underlying conditions like diabetes, hypertension, and other cardiovascular diseases.

Objective: to comprehensively investigate the direct and indirect economic burden of glaucoma among adults in the U.S.

Methods: A cross-sectional study will be performed using MEPS 2015-2017. Direct healthcare (HC) cost and indirect cost (employment, wages, missed days, and cost to loss of productivity LOP) were compared between adults with and without Glaucoma. Propensity score matching (PS) to control for baseline differences and linear regression with logarithmic transformation to identify predictors of total healthcare expenditure will be incorporated. All expenses will be adjusted to 2020 USD.

Results: There were 5.6 million adults with glaucoma in the US. The prevalence of glaucoma is 2.22%. Patients with glaucoma had significantly higher direct costs (PPPY Mean diff. of total healthcare cost was $5,188 p-value <.0001). Glaucoma patients were vulnerable to significantly higher costs for prescription drugs, office-based visits, and other medical services (p-value <0.05). In terms of indirect cost, the estimated Indirect Cost to Loss of Productivity due to glaucoma was $42,037 per person per year. Potential risk factors behind the increased direct cost were being older than 65, white, diagnosed with cancer or diabetes or arthritis or asthma, and having poor health and mental status.

Conclusion: Patients with glaucoma showed significantly higher direct and indirect economic costs. Measures to minimize the cost and improve disease management are recommended.