Trends in Spending on Corrective Lenses

Importance About 50% of the population has a refractive error, but corrective lenses can impose cost barriers on patients given the lack of widespread vision insurance. Objective To describe temporal trends and sociodemographic variation in corrective lens spending and payment source (third party vs out-of-pocket). Design, Setting, and Participants This survey-based study used data from respondents to the 2010 through 2023 Medical Expenditure Panel Survey (N = 155 928). Annual response rates varied between 26.1% to 53.5%. These data were analyzed from March 2025 to July 2026. Exposures Temporal trends and sociodemographic variation. Main Outcomes and Measures The prevalence of any corrective lens spending, average spending among those with positive amounts, and the percent of those with positive spending that financed all purchases completely out-of-pocket. Results In 2023, 19.94% (95% CI, 19.06-20.83) of the population had positive spending on corrective lenses and the mean (SD) expenditure was $439.59 ($390.22). About half of people with positive spending (48.14%; 95% CI, 45.75%-50.53%) financed all purchases out-of-pocket. There was an increase in the percentage of people with any spending (2.62; 95% CI, 1.67-3.57) in mean spending amounts ($32.07; 95% CI, $12.49-$51.64), and a decline in 100% out-of-pocket burden (−10.38; 95% CI, −13.55 to −7.20) between 2010 and 2017, but not between 2018 and 2023. On an adjusted basis in the 2018 to 2023 period, spending outcomes increased with age; 65- to 74-year olds were 12.27 percentage points (95% CI, 11.40-13.14) more likely to have any spending and they had higher mean spending by $129.34 (95% CI, $87.37-$171.31), and were 18.78 percentage points (95% CI, 16.10-21.47) more likely to finance all spending out-of-pocket, compared with respondents who were 20 years and younger. The uninsured were 34.6 percentage points (95% CI, 31.52-37.70) more likely to be 100% out-of-pocket compared with those with private health insurance. Conclusions and Relevance These findings suggest that corrective lens spending can be substantial. Since many individuals completely pay for these purchases out of-pocket, costs might impede access and produce financial burdens. These results might inform policy discussions regarding coverage of routine vision services in public programs (eg, Medicaid and Medicare) and increased regulation of the vision insurance and eyewear markets.