Incidence of corneal adverse events in patients with multiple myeloma and their clinical and economic impact: A real-world retrospective cohort study

Figures & data

Figure 1. Schema of MM and hematology cohorts entry timeline. Abbreviation. MM, multiple myeloma.

Table 1. Baseline demographics and characteristics of the MM cohort by corneal AEs of interest (n = 2,120).

	All corneal AEs* (n = 248)	Keratopathy/keratitis (n = 52)	Blurred vision/decreased acuity (n = 73)	Dry eye (n = 129)	Eye pain (n = 23)	Photophobia (n = 5)
Age (years), mean (SD)	60.9 (9.9)	63.4 (9.0)	59.0 (9.8)	61.7 (10.1)	60.3 (9.9)	63.0 (10.7)
Age group, years, n (%)
18–44	12 (4.8)	1 (1.9)	5 (6.9)	5 (3.9)	1 (4.4)	0 (0)
45–54	48 (19.4)	6 (11.5)	17 (23.3)	25 (19.4)	5 (21.7)	0 (0)
55–64	115 (46.4)	23 (44.2)	38 (52.1)	57 (44.2)	9 (39.1)	4 (80.0)
65–74	46 (18.6)	15 (28.9)	6 (8.2)	26 (20.2)	6 (26.1)	0 (0)
≥75	27 (10.9)	7 (13.5)	7 (9.6)	16 (12.4)	2 (8.7)	1 (20.0)
Female, n (%)	124 (50.0)	20 (38.5)	37 (50.7)	70 (54.3)	14 (60.9)	2 (40.0)
Index year, n (%)
2012–2014	163 (65.7)	38 (73.1)	48 (65.8)	81 (62.8)	16 (69.6)	3 (60.0)
2015–2017	85 (34.3)	14 (26.9)	25 (34.3)	48 (37.2)	7 (30.4)	2 (40.0)
Geographic region, n (%)
Northeast	64 (25.8)	11 (21.2)	21 (28.8)	32 (24.8)	6 (26.1)	3 (60.0)
Midwest	72 (29.0)	18 (34.6)	19 (26.0)	36 (27.9)	8 (34.8)	0 (0)
South	78 (31.6)	18 (34.6)	22 (30.1)	44 (34.1)	4 (17.4)	2 (40.0)
West	32 (12.9)	4 (7.7)	11 (15.1)	17 (13.2)	4 (17.4)	0 (0)
Unknown	2 (0.8)	1 (1.9)	0 (0)	0 (0)	1 (4.4)	0 (0)
Health plan type, n (%)
Consumer directed	1 (0.4)	1 (1.9)	0 (0)	0 (0)	0 (0)	0 (0)
HMO	42 (16.9)	7 (13.5)	13 (17.8)	19 (14.7)	8 (34.8)	1 (20.0)
Indemnity	3 (1.2)	2 (3.9)	0 (0)	1 (0.8)	1 (4.4)	0 (0)
POS	10 (4.0)	3 (5.8)	2 (2.7)	6 (4.7)	0 (0)	0 (0)
PPO	191 (77.0)	38 (73.1)	58 (79.5)	102 (79.1)	14 (60.9)	4 (80.0)
Unknown	1 (0.4)	1 (1.9)	0 (0)	1 (0.8)	0 (0)	0 (0)
Payer type, n (%)
Commercial	154 (62.1)	31 (59.6)	45 (61.6)	84 (65.1)	11 (47.8)	5 (100.0)
Medicaid	9 (3.63)	2 (3.9)	4 (5.5)	3 (2.33)	2 (8.7)	0 (0)
Medicaid R	12 (4.8)	5 (9.6)	2 (2.7)	7 (5.4)	1 (4.4)	0 (0)
Self-insured	67 (27.0)	12 (23.1)	22 (30.1)	32 (24.8)	7 (30.4)	0 (0)
Unknown	6 (2.4)	2 (3.9)	0 (0)	3 (2.8)	2 (8.7)	0 (0)

*Patients with ≥1 corneal AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

Abbreviations. AE, adverse event; HMO, health maintenance organization; MM, multiple myeloma; POS, point of service; PPO, preferred provider organization; SD, standard deviation.

Table 2. Overall rate of incident corneal AEs of interest in the MM cohort by LOT.

	All lines of therapy* (n = 2,120)	1st line (n = 2,120)	2nd line (n = 1,430)	3rd line (n = 799)	≥4th line (n = 390)
Overall (IP, OP, or ED setting), n (%)	248 (11.7)	121 (5.7)	67 (4.7)	40 (5.0)	25 (6.4)
Keratopathy/keratitis	52 (2.5)	17 (0.8)	19 (1.3)	10 (1.3)	6 (1.5)
Blurred vision/decreased acuity	73 (3.4)	36 (1.7)	16 (1.1)	10 (1.3)	11 (2.8)
Dry eye	129 (6.1)	61 (2.9)	34 (2.4)	25 (3.1)	9 (2.3)
Eye pain	23 (1.1)	16 (0.8)	3 (0.2)	2 (0.3)	2 (0.5)
Photophobia	5 (0.2)	3 (0.1)	1 (0.1)	1 (0.1)	0 (0)
IP or ED setting, n (%)	18 (0.8)	9 (0.4)	4 (0.3)	2 (0.3)	3 (0.8)
Keratopathy/keratitis	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
Blurred vision/decreased acuity	7 (0.3)	4 (0.2)	1 (0.1)	1 (0.1)	1 (0.3)
Dry eye	1 (0.0)	0 (0)	0 (0)	0 (0)	1 (0.3)
Eye pain	8 (0.4)	4 (0.2)	2 (0.1)	1 (0.1)	1 (0.3)
Photophobia	2 (0.1)	1 (0.0)	1 (0.1)	0 (0)	0 (0)
OP setting, n (%)	233 (11.0)	113 (5.3)	64 (4.5)	38 (4.8)	22 (5.6)
Keratopathy/keratitis	52 (2.5)	17 (0.8)	19 (1.3)	10 (1.3)	6 (1.5)
Blurred vision/decreased acuity	66 (3.1)	32 (1.5)	15 (1.0)	9 (1.1)	10 (2.6)
Dry eye	128 (6.0)	61 (2.9)	34 (2.4)	25 (3.1)	8 (2.1)
Eye pain	15 (0.7)	12 (0.6)	1 (0.1)	1 (0.1)	1 (0.3)
Photophobia	3 (0.1)	2 (0.1)	0 (0)	1 (0.1)	0 (0)
OP setting: Subset ophthalmologist/optometrist, n (%)	162 (7.6)	81 (3.8)	44 (3.1)	28 (3.5)	11 (2.8)
Keratopathy/keratitis	45 (2.1)	15 (0.7)	16 (1.1)	9 (1.1)	5 (1.3)
Blurred vision/decreased acuity	23 (1.1)	14 (0.7)	5 (0.3)	2 (0.3)	2 (0.5)
Dry eye	104 (4.9)	50 (2.4)	26 (1.8)	22 (2.8)	6 (1.5)
Eye pain	9 (0.4)	8 (0.4)	0 (0)	1 (0.1)	0 (0)
Photophobia	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)

*Not including gaps between LOT.

Abbreviations. AE, adverse event; ED, emergency department; IP, inpatient; LOT, line of therapy; MM, multiple myeloma; OP, outpatient.

Table 3. Healthcare resource utilization* (per-patient-per-month^†) for corneal AEs of interest in the MM cohort (n = 2,120).

	All corneal AEs^‡ (n = 248)	Keratopathy/keratitis (n = 52)	Blurred vision/decreased acuity (n = 73)	Dry eye (n = 129)	Eye pain (n = 23)	Photophobia (n = 5)
Ophthalmic prescriptions filled in pharmacy
Proportion with ≥ 1 prescription, n (%)	97 (39.1)	21 (40.4)	17 (23.3)	50 (38.8)	18 (78.3)	1 (20.0)
Number of prescriptions, mean (median)	0.7 (0.2)	0.4 (0.2)	0.3 (0.2)	0.4 (0.2)	0.2 (0.1)	6.2 (6.2)
Corneal AE-related
Proportion with ≥ 1 hospital visit, n (%)	9 (3.6)	0 (0)	5 (6.8)	0 (0)	3 (13.0)	0 (0)
Number of visits, mean (median)	0.3 (0.1)	0 (0)	0.4 (0.1)	0 (0)	0.2 (0.1)	0 (0)
LOS (months), mean (median)	0.3 (0.1)	0 (0)	0.4 (0.1)	0 (0)	0.2 (0.1)	0 (0)
Corneal AE-related ED visits
Proportion with ≥ 1 corneal AE-related ED visit, n (%)	12 (4.8)	1 (1.9)	3 (4.1)	1 (0.8)	5 (21.7)	2 (40.0)
Number of visits, mean (median)	0.1 (0.1)	0.2 (0.2)	0.1 (0.1)	0.5 (0.5)	0.1 (0.1)	0.1 (0.1)
Corneal AE-related physician office/OP visits
Proportion with ≥ 1 corneal AE-related physician office/OP visit, n (%)	238 (96.0)	52 (100.0)	68 (93.2)	128 (99.2)	19 (82.6)	4 (80.0)
Number of visits, mean (median)	0.4 (0.1)	0.2 (0.1)	0.6 (0.1)	0.2 (0.1)	0.2 (0.1)	0.1 (0.1)
Corneal AE-related ophthalmologist/optometrist visits
Proportion with ≥ 1 corneal AE-related ophthalmologist/optometrist visit, n (%)	171 (69.0)	47 (90.4)	26 (35.6)	106 (82.2)	11 (47.8)	0 (0)
Number of visits, mean (median)	0.4 (0.1)	0.2 (0.1)	0.1 (0.1)	0.2 (0.1)	0.1 (0.1)	0 (0)
Proportion with ≥ 1 corneal AE-related ophthalmologist visit, n (%)	106 (42.7)	26 (50.0)	18 (24.7)	64 (49.6)	9 (39.1)	0 (0)
Number of visits, mean (median)	0.2 (0.1)	0.2 (0.1)	0.1 (0.1)	0.2 (0.1)	0.1 (0.1)	0 (0)
Proportion with ≥ 1 corneal AE-related optometrist visit, n (%)	76 (30.6)	25 (48.1)	10 (13.7)	45 (34.9)	2 (8.7)	0 (0)
Number of visits, mean (median)	0.6 (0.1)	0.2 (0.1)	0.1 (0.1)	0.2 (0.1)	0.1 (0.1)	0 (0)
Corneal AE-related non-ophthalmologist/non-optometrist visits
Proportion with ≥ 1 corneal AE-related non-ophthalmologist/non-optometrist visit, n (%)	98 (39.5)	9 (17.3)	48 (65.8)	31 (24.0)	11 (47.8)	4 (80.0)
Number of visits, mean (median)	0.5 (0.1)	0.1 (0.1)	0.7 (0.2)	0.2 (0.1)	0.2 (0.1)	0.1 (0.1)

*Corneal AE-related HCRU was calculated from the date of incident corneal AE (not from LOT start date). HCRU was assessed from incident corneal AE date to end of follow-up. Corneal AE-related HCRU are assessed using claims with ICD-9 or ICD-10 diagnosis codes of corneal AE at any position for outpatient and ED visits, primary admission diagnosis, or discharge diagnosis for inpatient admissions.

^†Reporting on PPPM basis used the follow-up months post-incident corneal AE distribution and calculated PPPM HCRU. For reporting overall ocular condition related HCRU, in the case of patients with multiple corneal AEs, the earliest incidence date was used to assess follow-up time.

^‡Patients with ≥1 AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

Abbreviations. AE, adverse event; ED, emergency department; HCRU, healthcare resource utilization; ICD, International Classification of Diseases; MM, multiple myeloma; LOS, length of stay; LOT, line of therapy; OP, outpatient; PPPM, per-patient-per-month.

Table 4. Healthcare costs* (median per-patient-per-month) for each corneal AEs of interest in the MM cohort (n = 2,120).

	All corneal AEs^† (n = 248)	Keratopathy/ keratitis (n = 52)	Blurred vision/ decreased acuity (n = 73)	Dry eye (n = 129)	Eye pain (n = 23)	Photophobia (n = 5)
Overall corneal AE-costs^‡ among people with ≥ 1 corneal AE-related claim, $	27	22	41	19	39	256
Ophthalmic therapy prescription costs, $	16	22	16	19	5	1,612
Corneal AE-related IP services
Corneal AE-related hospitalization costs, $	16	0	16	0	39	0
Corneal AE-related ED visit costs, $	66	715	6	1,578	37	99
Corneal AE-related OP/physician office visit costs, $	19	13	35	12	22	89
Corneal AE-related ophthalmologist/optometrist visit costs, $	14	12	15	12	6	0
Corneal AE-related non-ophthalmologist/non-optometrist visit costs, $	33	9	109	12	32	89

*Corneal AE-related costs are calculated from the date of incident corneal AE (not from LOT start date) and are assessed using claims with ICD-9 or ICD-10 diagnosis codes of ocular AE at any position for outpatient and ED visits, primary admission diagnosis, or discharge diagnosis for inpatient admissions.

^†Patients with ≥1 corneal AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

^‡Costs are shown in US dollars. For corneal AE-related prescription, hospitalization, ED visit, outpatient/physician office visit, ophthalmologist/optometrist visit, or non-ophthalmologist/non-optometrist visit are for people with ≥1 corneal AE-related prescription, hospitalization, ED visit, outpatient/physician office visit, ophthalmologist/optometrist visit, or non-ophthalmologist/non-optometrist visit, respectively.

Abbreviations. AE, adverse event; ED, emergency department; ICD, International Classification of Diseases; IP, inpatient; LOT, line of therapy; MM, multiple myeloma; OP, outpatient.

Table 5. All-cause, MM-related, and corneal AEs-related healthcare costs* (median per-patient-per-month) in the MM cohort.

	All-cause (n = 2,120)	MM-related (n = 2,120)	Corneal AE-related^†,‡ (n = 2,120)
Total costs, $
Mean	19,762	15,053	780
SD	15,137	10,898	9,835
Median	17,286	13,851	27
Pharmacy costs, $
Mean	5,123	4,682	79
SD	4,248	4,028	214
Median	4,802	4,417	16
Hospitalization costs, $
Mean	7,023	4,115	32
SD	11,164	6,082	40
Median	4,316	2,322	16
ED costs, $
Mean	162	117	231
SD	347	359	467
Median	69	42	66
Outpatient/office visit costs, $^§
Mean	9,420	7,794	765
SD	8,653	7,487	9,928
Median	7,240	6,054	19

*Costs are shown in US dollars. Corneal AE-related costs are calculated from the date of incident corneal AE (not from LOT start date) and are assessed using claims with ICD-9 or ICD-10 diagnosis codes of ocular AE at any position for outpatient and ED visits, primary admission diagnosis, or discharge diagnosis for inpatient admissions.

^†Patients with ≥1 corneal AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

^‡For corneal AE-related prescription, hospitalization, ED visit, outpatient/physician office visit, ophthalmologist/optometrist visit, or non-ophthalmologist/non-optometrist visit are for people with ≥1 corneal AE-related prescription, hospitalization, ED visit, outpatient/physician office visit, ophthalmologist/optometrist visit, or non-ophthalmologist/non-optometrist visit, respectively.

^§For corneal AE-related costs, outpatient/office visits include outpatient/physician office visits, ophthalmologist/optometrist visits, and non-ophthalmologist/non-optometrist visits.

Abbreviations. AE, adverse event; ED, emergency department; ICD, International Classification of Diseases; LOT, line of therapy; MM, multiple myeloma.

Table

(A)
Attrition step and inclusion criteria	Remaining participants, n (%)
1. At least two diagnoses (ICD-9 203.0x, ICD-10 C90.0x) of MM, ≥30 days apart during the index period (1 January 2012 to 31 December 2016). Date of first diagnosis is index date	20,698 (100.0)
2. Aged ≥18 years at index date (first MM diagnosis)	20,644 (99.7)
3. Received ≥1 MM treatment of interest* after the index period	14,031 (67.8)
4. Continuous enrollment for ≥12 months pre-index period	8,033 (38.8)
5. Continuous enrollment for ≥12 months post-index period	5,754 (27.8)
6. Without ≥2 diagnoses for other lymphomas and/or leukemias for ≥30 days during the study period	5,007 (24.2)
7. Without any diagnosis of MM and without any claim for MM treatment^† within the 12-month pre-index period	2,120 (10.2)
8. Without data quality issues (invalid dates for birth year, gender, or health plan enrollment)	2,120 (10.2)

*Treatments of interest included bortezomib, carfilzomib, cyclophosphamide, daratumumab, doxorubicin (liposomal), elotuzumab, ixazomib, lenalidomide, melphalan, panobinostat, pomalidomide, thalidomide, vincristine, dexamethasone, and prednisone.

^†Treatments of interest included bortezomib, carfilzomib, cyclophosphamide, daratumumab, doxorubicin (liposomal), elotuzumab, ixazomib, lenalidomide, melphalan, panobinostat, pomalidomide, thalidomide, and vincristine. Patients with pre-index use of dexamethasone and prednisone were not excluded.

Abbreviations. ICD, International Classification of Diseases; MM, multiple myeloma.

Table

(B).
Attrition step and inclusion criteria	Remaining participants, n (%)
1. At least two diagnoses of a lymphatic or hematopoietic malignant neoplasm (ICD-9 200–209, ICD-10 C81-C96), ≥30 days apart during the index period (1 January 2012 to 31 December 2016). Date of first diagnosis of interest is index date	194,403 (100.0)
2. Aged ≥18 years at the index date (the date of first multiple myeloma diagnosis)	184,202 (94.8)
3. Received ≥2 claims of chemotherapy or targeted therapy within 1 year of initial diagnosis	63,075 (32.4)
4. Continuous enrollment for ≥12 months post-index period	44,010 (22.6)
5. Without data quality issues (invalid dates for birth year, gender, or health plan enrolment)	44,008 (22.6)
6. Continuous enrollment for ≥12 months pre-index period	26,923 (13.8)

Abbreviations. ICD, International Classification of Diseases.

Table

	All corneal AEs* (n = 1,989)	Keratopathy/ keratitis (n = 343)	Blurred vision/ decreased acuity (n = 599)	Dry eye (n = 1,022)	Eye pain (n = 176)	Photophobia (n = 75)
Mean age, years (SD)	57.29 (13.9)	57.82 (13.7)	54.94 (14.5)	58.98 (13.2)	55.61 (14.8)	51.13 (13.7)
Age group, years, n (%)
18–34	163 (8.2)	32 (9.3)	66 (11.0)	61 (6.0)	18 (10.2)	11 (14.7)
35–44	140 (7.0)	17 (5.0)	55 (9.2)	60 (5.9)	15 (8.5)	8 (10.7)
45–54	382 (19.2)	52 (15.2)	122 (20.4)	194 (19.0)	38 (21.6)	22 (29.3)
55–64	757 (38.1)	148 (43.2)	219 (36.6)	383 (37.5)	62 (35.2)	29 (38.7)
65–74	343 (17.2)	60 (17.5)	93 (15.5)	199 (19.5)	27 (15.3)	3 (4.0)
≥75	204 (10.3)	34 (9.9)	44 (7.4)	125 (12.2)	16 (9.1)	2 (2.7)
Female, n (%)	1,037 (52.1)	175 (51.0)	295 (49.3)	567 (55.5)	94 (53.4)	38 (50.7)
Index year, n (%)
2012–2014	1,406 (70.7)	232 (67.6)	395 (65.9)	751 (73.5)	137 (77.8)	50 (66.7)
2015–2017	583 (29.3)	111 (32.4)	204 (34.1)	271 (26.5)	39 (22.2)	25 (33.3)
Geographic region, n (%)
Northeast	489 (24.6)	91 (26.5)	140 (23.4)	247 (24.2)	43 (24.4)	18 (24.0)
Midwest	539 (27.1)	91 (26.5)	163 (27.2)	285 (27.9)	47 (26.7)	17 (22.7)
South	699 (35.1)	104 (30.3)	217 (36.2)	362 (35.4)	62 (35.2)	32 (42.7)
West	239 (12.0)	54 (15.7)	75 (12.5)	115 (11.3)	21 (11.9)	7 (9.3)
Unknown	23 (1.2)	3 (0.9)	4 (0.7)	13 (1.3)	3 (1.7)	1 (1.3)
Health plan type, n (%)
Consumer directed	8 (0.4)	1 (0.3)	1 (0.2)	4 (0.4)	2 (1.1)	0 (0)
HMO	255 (12.8)	38 (11.1)	74 (12.4)	137 (13.4)	23 (13.1)	10 (13.3)
Indemnity	78 (3.9)	16 (4.7)	26 (4.3)	42 (4.1)	6 (3.4)	2 (2.7)
POS	83 (4.2)	11 (3.2)	25 (4.2)	40 (3.9)	11 (6.3)	5 (6.7)
PPO	1,548 (77.8)	274 (79.9)	466 (77.8)	791 (77.4)	134 (76.1)	58 (77.3)
Unknown	17 (0.9)	3 (0.9)	7 (1.2)	8 (0.8)	0 (0)	0 (0)

*Patients with ≥1 corneal AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

Abbreviations. AE, adverse event; HMO, health maintenance organization; POS, point of service; PPO, preferred provider organization; SD, standard deviation.

Table

	Hematology cohort (n = 26,293)
IP, OP, or ED setting, n (%)	1,989 (7.4)
Keratopathy/keratitis	343 (1.3)
Blurred vision/decreased acuity	599 (2.2)
Dry eye	1,022 (3.8)
Eye pain	176 (0.7)
Photophobia	75 (0.3)
IP or ED setting, n (%)	226 (0.8)
Keratopathy/keratitis	16 (0.1)
Blurred vision/decreased acuity	128 (0.5)
Dry eye	19 (0.1)
Eye pain	52 (0.2)
Photophobia	19 (0.1)
OP setting, n (%)	1,787 (6.6)
Keratopathy/keratitis	327 (1.2)
Blurred vision/decreased acuity	471 (1.7)
Dry eye	1,003 (3.7)
Eye pain	124 (0.5)
Photophobia	56 (0.2)
OP setting: Subset ophthalmologist/optometrist, n (%)	1,129 (4.2)
Keratopathy/keratitis	250 (0.9)
Blurred vision/decreased acuity	150 (0.6)
Dry eye	737 (2.7)
Eye pain	61 (0.2)
Photophobia	26 (0.1)

Abbreviations. AE, adverse event; ED, emergency department; IP, inpatient; OP, outpatient.

Table

	All corneal AEs* (n = 1989)	Keratopathy/ keratitis (n = 343)	Blurred vision/ decreased acuity (n = 599)	Dry eye (n = 1,022)	Eye pain (n = 176)	Photophobia (n = 75)
Ophthalmic prescriptions filled in the pharmacy
Proportion with ≥ 1 prescription, n (%)	871 (43.8)	207 (60.3)	209 (34.9)	456 (44.6)	104 (59.1)	30 (40.0)
Number of prescriptions, mean (median)	0.33 (0.1)	0.31 (0.2)	0.26 (0.14)	0.26 (0.1)	0.23 (0.1)	0.31 (0.1)
Corneal AE-related hospitalizations
Proportion with ≥ 1 hospital visit, n (%)	128 (6.4)	12 (3.5)	70 (11.7)	20 (2.0)	20 (11.4)	3 (4.0)
Number of visits, mean (median)	0.14 (0.1)	0.24 (0.0)	0.16 (0.1)	0.13 (0.0)	0.03 (0.0)	0.05 (0.0)
LOS (months), mean (median)	0.38 (0.1)	0.72 (0.1)	0.25 (0.1)	1.04 (0.0)	0.04 (0.0)	0.05 (0.0)
Corneal AE-related ED visits
Proportion with ≥ 1 corneal AE-related ED visit, n (%)	138 (6.9)	5 (1.5)	76 (12.7)	5 (0.5)	34 (19.3)	16 (21.3)
Number of visits, mean (median)	0.10 (0.1)	0.06 (0.1)	0.08 (0.1)	0.06 (0.1)	0.08 (0.0)	0.27 (0.1)
Corneal AE-related physician office/OP visits
Proportion with ≥ 1 corneal AE-related physician office/OP visit, n (%)	1,868 (93.9)	334 (97.4)	522 (87.1)	1,010 (98.8)	140 (79.5)	61 (81.3)
Number of visits, mean (median)	0.19 (0.1)	0.18 (0.1)	0.20 (0.1)	0.15 (0.1)	0.15 (0.1)	0.08 (0.1)
Corneal AE-related ophthalmologist/optometrist visits
Proportion with ≥ 1 corneal AE-related ophthalmologist/  optometrist visit, n (%)	1,255 (63.1)	265 (77.3)	175 (29.2)	793 (77.6)	70 (39.8)	26 (34.7)
Number of visits, mean (median)	0.13 (0.1)	0.16 (0.1)	0.09 (0.1)	0.12 (0.1)	0.10 (0.1)	0.06 (0.0)
Proportion with ≥ 1 corneal AE-related ophthalmologist visit, n (%)	863 (43.4)	167 (48.7)	125 (20.9)	559 (54.7)	44 (25.0)	13 (17.3)
Number of visits, mean (median)	0.14 (0.1)	0.16 (0.1)	0.09 (0.1)	0.12 (0.1)	0.10 (0.1)	0.05 (0.0)
Proportion with ≥ 1 corneal AE-related optometrist visit, n (%)	480 (24.1)	116 (33.8)	56 (9.3)	280 (27.4)	28 (15.9)	13 (17.3)
Number of visits, mean (median)	0.11 (0.1)	0.14 (0.1)	0.09 (0.1)	0.09 (0.1)	0.08 (0.1)	0.07 (0.1)
Corneal AE-related non-ophthalmologist/non-optometrist visits
Proportion with ≥ 1 corneal AE-related non-ophthalmologist/  non-optometrist visit, n (%)	919 (46.2)	100 (29.2)	395 (65.9)	356 (34.8)	80 (45.5)	36 (48.0)
Number of visits, mean (median)	0.20 (0.1)	0.16 (0.1)	0.22 (0.1)	0.16 (0.1)	0.18 (0.1)	0.10 (0.1)

*Patients with ≥1 corneal AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

Abbreviations. AE, adverse event; ED, emergency department; IP, inpatient; LOS, length of stay; OP, outpatient.

Table

	All corneal AEs* (n = 1,989)	Keratopathy/ keratitis (n = 343)	Blurred vision/ decreased acuity (n = 599)	Dry eye (n = 1,022)	Eye pain (n = 176)	Photophobia (n = 75)
Overall corneal AE-costs^† among people with ≥ 1 corneal AE-related claim, mean (median), $	166 (20)	95 (19)	258 (30)	109 (16)	74 (16)	147 (15)
Ophthalmic therapy prescription costs among people with ≥ 1 ophthalmic prescription, mean (median), $	45 (10)	37 (13)	25 (8)	40 (13)	25 (5)	74 (4)
Corneal AE-related IP hospitalization costs, mean (median), $	68 (10)	175 (10)	68 (10)	78 (10)	8 (4)	14 (2)
Corneal AE-related IP ED visit costs, mean (median), $	106 (17)	59 (21)	99 (19)	15 (13)	108 (11)	159 (22)
Corneal AE-related OP/physician office visit costs, mean (median), $	143 (13)	67 (10)	263 (22)	91 (11)	48 (8)	102 (9)
Corneal AE-related ophthalmologist/optometrist visit cost, mean (median), $	23 (10)	22 (8)	18 (9)	21 (10)	13 (7)	9 (6)
Corneal AE-related non-ophthalmologist/non-optometrist visit cost, mean (median), $	260 (20)	168 (13)	340 (34)	209 (15)	72 (8)	167 (24)

*Patients with ≥1 corneal AE of keratopathy/keratitis, blurred vision/decreased acuity, dry eye, eye pain, or photophobia.

^†Costs are shown in US dollars. For corneal AE-related hospitalization, ED visit, outpatient/physician office visit, ophthalmologist/optometrist visit, or non-ophthalmologist/non-optometrist visit are for people with ≥1 corneal AE-related hospitalization, ED visit, outpatient/physician office visit, ophthalmologist/optometrist visit, or non-ophthalmologist/non-optometrist visit, respectively.

Abbreviations. AE, adverse event; ED, emergency department; IP, inpatient; OP, outpatient.

Data availability statement

GSK makes available anonymized individual participant data and associated documents from interventional clinical studies which evaluate medicines, upon approval of proposals submitted to www.clinicalstudydatarequest.com. To access data for other types of GSK sponsored research, for study documents without patient-level data, and for clinical studies not listed, please submit an enquiry via the website.