Economic burden of glaucoma in Nigeria: Estimating the direct health care cost in a tertiary eye clinic

Aim: To estimate the direct health care cost of glaucoma in patients attending glaucoma clinic at National Eye Centre, Kaduna. Methods: The study was a hospital-based observational, cross-sectional study of 150 consecutive glaucoma patients on follow-up visits to the glaucoma clinic from November, 2017 to January, 2018. The study was conducted using a structured interviewer-administered questionnaire. The study investigated the patients’ monthly income, the method of funding glaucoma treatment, and cost of treatment of glaucoma. Data obtained were entered and analyzed using SPSS version 24 with level of significance set at 95% confidence interval. Results: There were a total of 150 patients who participated in the study, with a male-to-female ratio of M:F ratio is 1.2:1. Majority of respondents (65%) in the study were below the age of 60 years with a mean age of 55.36 (SD+/−13.7). The average monthly income of respondents was NGN 4,600 for unskilled workers, NGN 28,812 for skilled workers, and NGN 97,111 for professionals. The mean monthly direct health cost was NGN 9,954 and majority (91.7%) of the patients fund their treatment out of pocket. Only 14 (9.3%) patients were subscribers of the National Health Insurance Scheme. None among the unskilled and unemployed respondents had monthly direct costs below their average monthly income. The insured patients spent an average of 1.5% and 4.5%, respectively of their total monthly income on antiglaucoma medication and glaucoma surgery unlike the uninsured group who have spent 10.1% and 10.5%, respectively on medications and surgery. Conclusion: Data from this study have shown that up to one-tenth of the monthly income can be spent on glaucoma care alone. Health policy makers should consider making glaucoma a priority disease to ensure that patients on treatment have affordable, equitable, and of good quality in order to prevent consequent glaucoma-related blindness.