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Mydriasert® versus standard eye drops to achieve mydriasis in patients undergoing cataract surgery: a budget impact analysis in the UK

Session Details

Session Title: Complex Cases and Surgery

Session Date/Time: Monday 07/10/2013 | 14:30-16:00

Paper Time: 14:36

Venue: Forum (Ground Floor)

First Author: : S.Johal UK

Co Author(s): :    P. Masoura              

Abstract Details

Purpose:

To evaluate the financial consequences of using an insoluble ophthalmic insert, Mydriasert®, in place of standard eye drops, typically tropicamide and phenylephrine drops, to achieve mydriasis in patients undergoing cataract surgery. Mydriasert® involves a single administration step whereas eye drops require repeated instillations by a nurse to achieve mydriasis.

Setting:

The analysis was carried out from a UK healthcare payer (National Health Service) perspective. Only direct medical costs were included

Methods:

A budget impact model was constructed to evaluate the budgetary implications of using Mydriasert® in cataract patients in the UK. For patients undergoing mydriasis the model captured nurse time and costs, cost of the insert and cost of eye drops. The model also captured costs of nurse training, costs of disposable items and the cost of additional anaesthetic eye drops. Data on the resource use, including nurse time required to administer eye drops, frequency of instillation of eye drops and nurse time required to insert Mydriasert® was obtained from interviews with five clinical experts from different UK eye centres. Data from a resource use study of Mydriasert® conducted by a hospital was also used to estimate resource use differences between using eye drops and Mydriasert®. Costs were modelled in a simulated UK cohort of 1000 cataract patients and all costs were reported in 2013 pounds sterling

Results:

Over the short term time horizon of the model, up to the point where patient"s pupil has returned to the normal size after surgery, the cohort of 1000 patients who had Mydriasert to achieve mydriasis incurred costs £6,406 lower than an equivalent cohort receiving eye drops (£8,400 and £14,806, respectively). The increased cost of Mydriasert compared with eye drops (£4.20 and £0.96, respectively) was more than offset by savings in nurse time when using Mydriasert.

Conclusions:

Based on the findings of the present analysis, the higher initial cost of Mydriasert is offset within the timeframe of surgery preparation and surgery time for patients who require mydriasis for cataract surgery. The cost associated with Mydriasert should not therefore be a barrier to its use in daily clinical practice.

Financial Interest:

... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented