A Canadian Cost-Utility Analysis of 2 Trabecular Microbypass Stents at Time of Cataract Surgery in Patients with Mild to Moderate Open-Angle Glaucoma.

Ophthalmology. Glaucoma
Iqbal Ike K AhmedRon Goeree

Abstract

To assess, from the Canadian public payer perspective, the cost-utility of implanting iStent Inject trabecular bypass stent (TBS) devices in conjunction with cataract surgery versus cataract surgery alone in patients with open-angle glaucoma (OAG) and visually significant cataract. Cost-utility analysis using efficacy and safety results of pivotal randomized clinical trial. Modeled cohort of patients with OAG (83.1% with mild disease, 16.9% with moderate disease) and visually significant cataract. Open-angle glaucoma treatment costs and effects were projected over a 15-year time horizon using a Markov model with Hodapp-Parrish-Anderson glaucoma stages (mild, moderate, advanced, severe or blind) and death as health states. Patients in the mild or moderate OAG health states received implantation of iStent Inject during cataract surgery versus cataract surgery alone. On worsening of visual field defect and optic disc damage, patients could receive selective laser trabeculoplasty and trabeculectomy. We measured treatment effect as reduction in intraocular pressure (IOP) and mean medication use and estimated transition probabilities based on efficacy-adjusted visual field mean deviation decline per month. Healthcare resource utiliza...Continue Reading

Citations

Aug 26, 2020·Journal of Cataract and Refractive Surgery·Wesam Shamseldin ShalabyDaniel Lee
Jun 21, 2020·Progress in Retinal and Eye Research·Gordana Sunaric Megevand, Alain M Bron
Mar 28, 2021·Ophthalmology. Glaucoma·Rachel W Kuchtey, Sylvia L Groth
Sep 11, 2021·Journal of Glaucoma·Abdelrahman M ElhusseinyWilliam E Smiddy

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