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Abstract #24656 Published in IGR 11-4
An economic analysis to evaluate anti-glaucoma pharmacotherapy
Bhowmik D; Sansgiry SSValue in Health 2009; 12: A75
OBJECTIVES: To compare the use of prostaglandin analogues namely, Bimatoprost, Travoprost and Latanoprost, in the treatment of glaucoma by conducting a cost effectiveness analysis considering medication related adverse event and patientpersistence as indirect costs. METHODS: The study was conducted from a thirdparty payer's (Medicare) perspective with a time-frame of 12 months. Literature review was conducted to estimate medical-visit costs, average reduction in intra-ocular pressure (IOP) in mm Hg, medications related adverse event and patient-persistence to the pharmacotherapy. Average wholesale price (AWP) for the drug considered (obtained from the REDBOOK-2007), mean number of drops per bottle (according to the best instillation method), days per bottle, and annual usage of bottles for these drugs were also obtained from published literature to determine the annual cost associated with prostaglandin pharmacotherapy. DATA (version 3.0) software package was used to perform the decision analysis. Incremental cost-effectiveness ratios (ICER) were calculated using intra-ocular-pressure reduction as effi cacy estimate. Sensitivity analyses were conducted by changing the cost information by 25% to account for the variation in drug administration. A discounting rate of 5% was used to project all cost estimates to year 2008. RESULTS: The decision-analysis indicated Travoprost to be slightly inexpensive among the three prostaglandins (expected value $616.33), followed by Bimatoprost (expected value $618.73) and Latanoprost (expected value $626.29). Compared with Latanoprost, Travoprost and Bimatoprost provided a higher IOP-reduction with ICER of $(?9.96) and $(?7.56) respectively. Results of sensitivity analyses were robust to the decision analysis performed. CONCLUSIONS: Based on our analysis Travoprost and Bimatoprost was more cost-effective than Latanoprost. Health care decision-makers should consider the effect of adverse drug events and persistency profi les on the direct medical costs to prioritize the prostaglandin analogues for long-term treatment of glaucoma. Further, analyses using adherence data for specifi c patient groups can provide valuable information to decision makers.
D. Bhowmik. University of Houston, HoustonUnited States.
Classification:
14 Costing studies; pharmacoeconomics
