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1 General aspects (0)   1.1 Epidemiology (8)   1.2 Population genetics (0)   1.3 Pathogenesis (1)   1.4 Quality of life (13)   1.5 Glaucomas as cause of blindness (4)   1.6 Prevention and screening (9) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (10)   2.2 Cornea (19)   2.3 Sclera (7)   2.4 Anterior chamber angle (7)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (15)     2.5.2 Schlemms canal (5)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (6)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (9)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (5)   2.9 Ciliary body (2)   2.10 Lens (0)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (6)   2.13 Retina and retinal nerve fibre layer (38)   2.14 Optic disc (36)   2.15 Optic nerve (4)   2.16 Chiasma and retrochiasmal central nervous system (14)   2.17 Stem cells (4)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (1)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (2)     3.4.2 Gene studies (20)   3.5 Molecular biology incl. 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Filtering surgery (0)     12.8.1 Without tube implant (23)     12.8.2 With tube implant or other drainage devices (84)     12.8.3 Non-perforating (10)     12.8.4 Using laser (0)     12.8.5 Other (10)     12.8.10 Woundhealing antifibrosis (12)     12.8.11 Complications, endophthalmitis (26)   12.9 Trabeculotomy, goniotomy (27)   12.10 Cyclodestruction (11)   12.11 Cyclodialysis (1)   12.12 Cataract extraction (1)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (8)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (1)     12.14.3 Phacoemulsification (31)   12.15 Capsulotomy (0)   12.16 Vitrectomy (4)   12.17 Anesthesia (2)   12.20 Other (3) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (10)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (1)       13.2.2.1 Progression (1)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (4) 15 Miscellaneous (36)

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Abstract #90620 Published in IGR 21-3

Cost-effectiveness and budget impact analysis of a patient visit support system for blindness reduction in Japanese patients with glaucoma

Yamada M; Nakano T; Matsuda H; Kim SW; Takagi Y
Journal of Medical Economics 2020; 23: 1293-1301

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AIM: To evaluate the cost-effectiveness (CE) and budget impact (BI) of introducing a patient visit support system (ACT Pack) along with standard of care (SoC), in glaucoma treatment in Japan. METHODS: A Markov model was designed to estimate the CE and BI of introducing the support system from Japanese payer and governmental perspective, respectively. Inputted data for CE and BI analysis were referred from published literature and based on medical specialists' inputs. Base case scenario for CE considered the support system cost of 30,000 yen per patient per year and a time horizon of 45 years. BI analysis compared the financial impact due to introduction of support system with SoC compared to SoC alone scenario on Japanese healthcare system with a time horizon of 20 years. RESULTS: The base case of CE analysis showed the incremental cost per quality-adjusted life years (QALYs) gained with the support system was 3,241,729 yen/QALY (29,470 USD/QALY). The sensitivity analysis showed that the probability of this support system being cost-effective at a threshold of 5 million yen/QALY (45,455 USD/QALY) was 53.26%. Blindness reduction after introduction of this support system was 8.68%. The BI analysis showed that the introduction of support system will lead to a cumulative cost savings of 1,132 billion yen (10 billion US dollars) for Japanese healthcare system over 20 years of time horizon. LIMITATION: Due to paucity of similar comparative studies, some assumptions were made based on medical specialists' inputs. Death status was not considered in the analysis. CONCLUSION: INTRODUCTION: of this support system with SoC is cost-effective and will lead to blindness reduction in Japanese patients with glaucoma. Over a 20 year period, it will lead to an overall cost savings of 1,132 billion yen (10 billion US dollars) for the Japanese healthcare system.

Department of Ophthalmology, Kyorin University School of Medicine, Mitaka, Japan.

Full article

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Classification:

14 Costing studies; pharmacoeconomics
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)

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