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Abstract #25841 Published in IGR 12-2
Cost benefit analysis of bimatoprost compared with other prostaglandin analogues in patients with primary open angle glaucoma (POAG) in the United States: A payer's perspective
Berenson K; Arora S; Kymes S; Hollander DA; Fiscella R; Burk C; Patel VJournal of Managed Care Pharmacy 2010; 16: 146
BACKGROUND:Glaucoma is a slowly progressive disease that can lead to blindness. Multiple, prospective, randomized clinical trials have demonstrated that bimatoprost achieves greater intraocular pressure (IOP) lowering compared with other prostaglandin analogues (PGA). However, few studies have evaluated the associated cost savings of lower IOP and its impact on glaucomatous progression. OBJECTIVE: To develop a cost benefit model from a payer's perspective to compare glaucomatous progression and costs among POAG patients treated with bimatoprost, latanoprost, or travoprost in the United States. METHODS: A health economic model was used to estimate glaucomatous progression for a cohort of POAG patients (baseline IOP 26 mm Hg) over 7 years. The absolute reduction in IOP from baseline secondary to treatment with a PGA was based on a systematic review of the literature; the base case model assumed a 1 mm Hg advantage of bimatoprost over latanoprost or travoprost. IOP was used to estimate the baseline mean deviation (MD) score in the worst eye and to determine the proportion of patients with MD score progression each year. Patients who progressed were assumed to progress at a mean rate of 0.6 decibels (dB) per year. Medical, pharmacy, and indirect costs associated with categories of MD scores from the published literature were applied to each treatment cohort to calculate the expected 7-year costs of treating patients with the different PGAs. Visual impairment costs were applied solely to severe disease patients. Costs were discounted at 3% per year. RESULTS: The results of the base case in this analysis showed that for a managed care plan of 1,000,000 members with 19,000 glaucoma patients, treatment with bimatoprost would prevent progression in 130 more patients compared with treatment with travoprost or latanoprost. The preservation of vision with bimatoprost resulted in cost savings of office visits, medication use, and surgeries, estimated at $796 per patient.There was an additional cost savings of $28 and $171 per treated patient in direct bimatoprost pharmacy costs compared with latanoprost and travoprost, respectively. The total cost savings with bimatoprost for a plan with 1,000,000 members, due to delayed/avoided progression, were estimated to be $103,480. CONCLUSIONS: Results from this model demonstrate that greater reduction in IOP from treatment with bimatoprost is associated with lower rates of glaucomatous progression and increased cost savings compared with latanoprost or travoprost.
C. Burk. Allergan, Inc., 2525 Dupont Dr., IrvineUnited States. Burk_Caroline@allergan.com
Classification:
14 Costing studies; pharmacoeconomics
11.4 Prostaglandins (Part of: 11 Medical treatment)