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Abstract #49037 Published in IGR 14-1
Cost-effectiveness of Medications Compared With Laser Trabeculoplasty in Patients With Newly Diagnosed Open-Angle Glaucoma
Stein JD; Kim DD; Peck WW; Giannetti SM; Hutton DWArchives of Ophthalmology 2012; 130: 497-505
See also comment(s) by Rupert Bourne • Ivan Goldberg • Kuldev Singh • Jeffrey Liebmann • Josh Stein •
OBJECTIVE: To determine the most cost-effective treatment option for patients with newly diagnosed mild open-angle glaucoma: observation only, treatment with generic topical prostaglandin analogs (PGAs), or treatment with laser trabeculoplasty (LTP). METHODS: Using a Markov model with a 25-year horizon, we compared the incremental cost-effectiveness of treating newly diagnosed mild open-angle glaucoma with PGAs, LTP, or observation only. RESULTS: The incremental cost-effectiveness of LTP over no treatment is $16 824 per quality-adjusted life year. By comparison, the incremental cost-effectiveness of PGAs over no treatment is $14,179 per quality-adjusted life year, and they provide greater health-related quality of life relative to LTP. If PGAs are 25% less effective owing to poor patient adherence, LTP can confer greater value. CONCLUSIONS: Prostaglandin analogs and LTP are both cost-effective options for the management of newly diagnosed mild open-angle glaucoma. Assuming optimal medication adherence, PGAs confer greater value compared with LTP. However, when assuming more realistic levels of medication adherence (making them 25% less effective than the documented effectiveness reported in clinical trials), at current prices for PGAs, LTP may be a more cost-effective alternative.
Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall St, Ann Arbor, MI, USA. jdstein@med.umich.edu
Full articleClassification:
14 Costing studies; pharmacoeconomics
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
11.4 Prostaglandins (Part of: 11 Medical treatment)
