Economic burden and loss of quality of life from dry eye disease in Canada

Abstract

Objective: To describe the direct and indirect cost estimates of dry eye disease (DED), stratified by disease severity, and the impact of DED on quality of life (QoL) in Canadian patients.

Methods and analysis: A prospective, multicentre, observational, cross-sectional study was conducted at six sites across Canada. Eligible patients completed a 20 min survey on demography, general health, disease severity, QoL and direct (resource utilisation and out-of-pocket expenses for the past 3-24 months) and indirect costs (absenteeism and presenteeism based on Work Productivity and Activity Impairment questionnaire responses). Subgroup analyses were performed according to DED severity and presence of Sjögren's syndrome.

Results: Responses from 146 of 151 participants were included in the analysis. DED was rated as moderate or severe by 19.2% and 69.2% of patients, respectively. Total mean annual costs of DED were $C24 331 (Canadian dollars) per patient and increased with patient-reported disease severity. Mean (standard deviation [SD]) indirect costs for mild, moderate and severe disease were $C5961 ($C6275), $C16 525 ($C11 607), and $C25 485 ($C22,879), respectively. Mean (SD) direct costs were $C958 ($C1216), $C1303 ($C1574) and $C2766 ($C7161), respectively. QoL scores were lowest in patients with Sjögren's syndrome (8.2% of cohort) and those with severe DED.

Conclusion: This study provides important insights into the negative impact of DED in a Canadian setting. Severe DED was associated with higher direct and indirect costs and lower QoL compared with those with mild or moderate disease. Increased costs and poorer QoL were also evident for patients with DED plus Sjögren's syndrome versus DED alone.

Keywords: clinical trial; ocular surface.

Figure 1

Mean annual costs due to DED. CAD, Canadian dollars; DED, dry eye disease.

Figure 2

Mean annual costs according to patient-reported DED severity. CAD, Canadian dollars; DED, dry eye disease.

Figure 3

Mean annual costs according to Sjögren’s syndrome status. CAD, Canadian dollars.

Figure 4

Average QoL subscale scores. Scores for the 12 VFQ 25 QoL subscales and the total QoL score, based on score ranges of 0–100, with lower scores indicating lower QoL. DED, dry eye disease; QoL, quality of life, VFQ, Visual Function Questionnaire.