OBJECTIVES: Ocular hypertension (OHT) and primary open-angle glaucoma (POAG) are chronic eye conditions that progress over time, potentially leading to blindness. Glaucoma management costs increase with disease severity and treatment switches, drugs and surgical treatments being cost drivers. Our study aimed to estimate this glaucoma management costs as a function of the disease stage and the number of treatment changes in Germany. METHODS: We analyzed patient-level data from an observational study with retrospective collection of medical resources used by German glaucoma patients over a 5-year period. Associated costs were derived for drug treatment, medical/surgical procedures, exams/tests and hospitalizations (Statutory Health Insurance, 2009 costs). A linear regression was performed on the total management costs and drug costs, with two independent variables: the current disease stage (OHT [reference], early, moderate, advanced POAG), and the number of treatment changes (0 [reference], 1, 2, ≥3 changes). Costs were estimated against the reference category (OHT-No change). RESULTS: Data from 154 OHT/POAG patients (57% female, mean age 67 +/-11 years) was analyzed. OHT patients without treatment change had a mean (SD) total management cost of €123 (121) per year, which increased by €71 (p>0.05), €153 (p>0.05) and €398 (p=0.004) in disease stages early, moderate and advanced POAG respectively. Each treatment line change (1, 2, ≥3) also resulted in increase in cost of €45 (p>0.05), €177 (p>0.05) and €451 (p<0.0001) compared to the reference cost, respectively. The drug cost followed the same pattern, with a mean (SD) reference cost of €83 (33) per year and increases by €70 (p>0.05), €88 (p=0.022) and €160 (p<0.0001) with the disease stage, and €22 (p>0.05), €76 (p=0.044) and €146 (p<0.0001) with each treatment change. CONCLUSIONS: The analysis of observational data showed a significant increase of the glaucoma management costs with both the disease severity and the number of treatment changes.