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Abstract #46881 Published in IGR 13-3
Cost-effectiveness of brinzolamide/timolol fixed combination (BTFC) versus dorzolamide/timolol fixed combination (DTFC) for patients with open angle glaucoma in Korea and Taiwan
Tan RValue in Health 2010; 13: 563
OBJECTIVES: To assess the cost-effectiveness of BTFC compared with DTFC using a payer perspective in Korea and Taiwan. METHODS: A 1-year decision analytic model simulated the effects on cohorts of open angle glaucoma patients in Korea and Taiwan from a payer perspective. Clinical effectiveness data (responder rates: percentage of patients that reach target intraocular pressure [IOP] of 18 mmHg) were derived from a non-inferiority phase III randomized clinical trial (RCT) of BTFC versus DTFC (Manni 2009). Comfort data were taken from a RCT comparing BTFC versus DTFC (Vold 2008). Compliance rates in relation to comfort (Barnebey 2000), risk of visual field defect (VFD) progression (Stewart 1993), and subsequent incremental medication utilization were estimated from literature. Medication costs were obtained from list prices. QALYs related to VFD were estimated from Korean-specific and other Asian published data sources. Costs and effects were discounted at three percent and expressed in local currency. Cost-effectiveness threshold level was set at equivalent to the respective country's gross domestic product (GDP) per capita. Sensitivity analyses were performed. RESULTS: The BTFC responder rate was 61% versus 59% for DTFC. Possibly due to the more physiological pH of the BTFC formulation, the discomfort rate was significantly better at 51% for BTFC and 83% for DTFC. BTFC economically dominated DTFC in Korea with 76,980 KRW savings and a gain of 0.02 QALYs. In Taiwan, Azarga was highly cost-effective with an incremental cost of 800 TWD, a QALY gain of 0.0259, and an incremental cost effectiveness ratio (ICER) of approximately 5% of GDP per capita. Sensitivity analyses demonstrated the robustness of these findings. CONCLUSIONS: BTFC is non-inferior to DTFC with regards to IOP lowering potential, has a significantly better comfort profile, and is highly cost-effective in both Korea and Taiwan.
R. Tan. Alcon Laboratories R and D International, Singapore, Singapore.
Classification:
14 Costing studies; pharmacoeconomics
11.13.4 Betablocker and prostaglandin (Part of: 11 Medical treatment > 11.13 Combination therapy)
