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Abstract #46876 Published in IGR 13-3
Cost-effectiveness analysis of travoprost followed by fixed combination travoprost/timolol treatment sequence (T-TTFC) compared to latanoprost followed by latanoprost/timolol fixed combination (L-LTFC) for patients with open angle glaucoma or ocular hyper
Taylor M; Tan RValue in Health 2010; 13: 509
OBJECTIVES: To assess the cost-effectiveness of T-TTFC compared with L-LTFC treatment sequences for patients with open angle glaucoma or ocular hypertension (OHT) using a payer perspective in Malaysia and India. METHODS: A Markov model simulated the disease progression of open angle glaucoma and ocular hypertension (OHT) patients in India and Malaysia. Transition probabilities were obtained from Denis (2008), and extrapolated from two phase III clinical trials (Topouzis, 2007; Netland; 2001). Probabilities to develop new visual field defect (VFD) was estimated from literature (Denis, 2004). Utilization patterns were derived from local hospitals and literature. Unit costs were obtained from list prices. The time horizon was 5 years and sensitivity analyses were performed on key parameters. RESULTS: At 5 years, fewer T-TTFC patients switched to third line treatment, and 65.5% of patients showed no disease progression (no new VFDs) compared to 61.4% for L-LTFC Thus initiation of treatment in an OHT patient with T followed by TTFC if needed would avoid one incidence of VFD in every 24 incident cases (Number Needed to Treat-NNT). In Malaysia, T-TTFC results in a cost-savings of 1286 RM (US$378) against L-LTFC. In India over a 5-year period, T-TTFC results in a cost savings of 11,184 INR (US$243) against L-LTFC. Sensitivity analyses have demonstrated the robustness of these finding. CONCLUSIONS: From the payer perspective, T-TTFC yielded costsavings and fewer treatment switches. Poor IOP control results in therapy changes and increases the probability of patients experiencing new VFDs (Denis 2004), which in turn adversely impacts patient quality of life. Our savings estimates are conservative because potential cost savings, as a consequence of fewer ophthalmologist visits, particularly for patients who use private healthcare facilities, have not been captured. With these findings policy-makers and clinicians should consider the use of T-TTFC for glaucoma patients as potential cost-saving medications.
M. Taylor. York Health Economics Consortium, York, United Kingdom.
Classification:
14 Costing studies; pharmacoeconomics
11.4 Prostaglandins (Part of: 11 Medical treatment)
11.13.4 Betablocker and prostaglandin (Part of: 11 Medical treatment > 11.13 Combination therapy)