Trends in Medical Expenses for Ocular Examinations in Japan Based on Nationwide Database Studies.

Introduction: Medical expenses, including ocular expenses, have been increasing annually in Japan. This study investigated national trends in the number of ocular examinations and examination expenses. Methods: This descriptive study used two national data sources: national medical expense estimates and statistics on medical care activities under public health insurance. We analyzed the medical expenses in Japan from 2008 to 2021 and estimated the proportions of different types of medical services. Results: Over 14 years, total medical expenses increased from 1.71 trillion yen to 2.31 trillion yen, with ocular medical expenses increasing from 64.5 billion yen to 96.0 billion yen. The total examination expenses increased from 155.2 billion yen to 231.5 billion yen, with ocular examination expenses increasing from 24.3 billion yen to 32.8 billion yen over 14 years. The examination expense category accounted for 32.3% of ocular medical expenses, although the overall examination expense category amounted to 10.0% of nationwide medical expenses in 2021. In particular, expenses related to optical coherence tomography (OCT) surged by 875.6%, visual field testing increased by 81.2%, corneal curvature measurement increased by 61.0%, and corneal endothelial cell density measurement increased by 59.3%. Only contact lens (CL) examination fees expenses decreased by 10.9%. In 2020, the coronavirus disease 2019 (COVID-19) pandemic caused a 24.8% and 22.0% decrease in ocular and nationwide examination expenses, respectively. Conclusions: Over 14 years, ocular medical expenses in Japan have increased by 49.0%, and nationwide medical expenses have increased by 35.1%. In addition, ocular examination expenses have increased by 35.0% over the past 14 years, although nationwide examination expenses have increased by 49.1%. All examination expenses increased except for CL examination fees. In particular, the OCT category witnessed a rapid increase. The COVID-19 pandemic has affected ocular examination expenses.