Free Papers

Cost-utility analysis of trabecular micro-bypass stents (TBS) in patients with mild-to-moderate open-angle glaucoma in Italy

Free Paper Details

First Author: A.Fea ITALY

Co Author(s):    H. Falvey   G. Buseghin   R. Bitonti              

Abstract Details

Purpose:

The objective of this study was to assess the cost-effectiveness of the iStent Inject® device in combination with cataract surgery vs. cataract surgery alone, in patients with mild-to-moderate primary open-angle glaucoma (POAG).

Setting:

Glaucoma is a group of ocular pathologies characterized by excessively high eye pressure. Frequently, glaucoma is accompanied by cataract. Patients with both conditions could receive a combined intervention of cataract surgery (phacoemulsification) and trabecular micro-bypass, iStent Inject®.

Methods:

A simulation of outcomes and costs of mild-to-moderate POAG patients was conducted, using a lifetime horizon Markov model, with 4 health states (defined according to the Hodapp-Parrish-Anderson classification) and one-month cycles. The Italian National Health Service (NHS) perspective was adopted. Clinical data were extracted from iStent Inject® clinical trials and published literature. In the model, only direct healthcare costs were considered: i) Costs of main and subsequent procedures; ii) Costs of medications; iii) Costs of disease monitoring; iv) Costs of adverse events. Model robustness was tested through sensitivity analyses

Results:

In the base-case, iStent Inject® + concurrent cataract surgery was more effective than cataract surgery alone (11.38 quality-adjusted life years - QALYs -, compared with 11.28 QALYs respectively). The use of iStent led to a slight increase of costs (+ € 1,235). Therefore, iStent Inject® + concurrent cataract surgery was cost-effective vs. cataract surgery alone, with an incremental cost-effectiveness ratio (ICER) of € 12,716.8 per QALY gained. Both one-way deterministic and probabilistic sensitivity analyses confirmed robustness and reliability of base-case results.

Conclusions:

The results of the cost-utility analysis confirm that iStent Inject® + cataract surgery is a cost-effective option for the treatment of patients with mild-to-moderate open-angle glaucoma, compared with cataract surgery alone, when evaluated from the Italian NHS perspective.

Financial Disclosure:

... is employed by a for-profit company with an interest in the subject of the presentation, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented