For this study, it is important only to account for prescription drug expenditure associated with the treatment of VI, and not the costs of all drugs used to treat eye conditions (e.g. preparations for acute eye infections and chronic conditions such as dry eye that may not cause VI).

It was hypothesised that the key prescription drugs associated with VI would include treatments for glaucoma, and recent treatments for AMD such as ranibizumab (Lucentis). Annual expenditure data on ophthalmic drugs in the ROI were obtained for the 12 months to November 2010 (IMS Health, data on file 2010). Specifically, the cost of prescription drugs for glaucoma included all expenditure on drug class S01E (anti-glaucoma preparations and miotics), and the cost of prescription drugs for AMD included all expenditure in drug class S01P (ocular anti-neovascular products). Annual expenditure totalled €10.79 million on drugs for glaucoma and €5.79 million on drugs for AMD. This is the total expenditure incurred by all health care payers, including both the government and patients.

The only previous study identified that reported prescription drug cost for VI in the ROI, was by Knox et al (2006) who analysed the cost and volume of public and private glaucoma drug prescriptions for the period 1996-2003. Knox et al (2006) estimated that €6.14 million was spent on glaucoma drugs in 2003, also using IMS Health data. The increased expenditure reported for 2010 is likely to represent increases in patient numbers and drug prices.

Access Economics (2009) found that, in the UK, treatment of glaucoma accounts for 71% of all prescriptions costs for eye therapy in 2008. When it is further considered that the remaining 29% of prescription costs may not be associated with the treatment of VI, then treatment of glaucoma is expected to account for the vast majority of prescription drug costs for VI. Access Economics (2009) associated the other 29% of prescription drug expenditure with anti-infective eye preparations, corticosteroids and other anti-inflammatory preparations, mydriatics and cycloplegics, local anaesthetics, and miscellaneous ophthalmic preparations. Many of these drugs are used in people with eye disorders who are not visually impaired.

Expenditure on prescriptions for glaucoma and AMD in 2010, 2015 and 2020 was estimated by applying estimated ROI population growth from 2010 (CSO 2008) to 2010 expenditure.

As presented in Table 3.5, expenditure on glaucoma drugs was estimated to be nearly €16.6 million in 2010 and is projected to rise to €19.4 million by 2020.

Table 3.5: Estimated expenditure on glaucoma drugs by all health care payers (€)

Source: Deloitte Access Economics calculations using IMS Health data and population growth reported by the CSO (2008; 2010b)

It should also be considered that pharmaceutical development may lead to increased prescription drug costs for AMD, glaucoma and other conditions associated with VI. However, this may in part be offset by a reduced prevalence of eye conditions for which more effective drugs become available.