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Is primary trabeculectomy cost-effective for patients with advanced primary open angle glaucoma? Results from the Treatment of Advanced Glaucoma Study economic model.
Shabaninejad, Hosein; Homer, Tara; Kernohan, Ashleigh; King, Anthony J; Burr, Jennifer; Azuara-Blanco, Augusto; Vale, Luke.
Afiliación
  • Shabaninejad H; Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
  • Homer T; Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
  • Kernohan A; Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
  • King AJ; Ophthalmology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Burr J; University of St Andrews School of Medicine, St Andrews, UK.
  • Azuara-Blanco A; Centre for Public Health, Queen's University Belfast Centre for Public Health, Belfast, UK.
  • Vale L; Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK luke.vale@ncl.ac.uk.
Br J Ophthalmol ; 108(9): 1210-1215, 2024 Aug 22.
Article en En | MEDLINE | ID: mdl-38336459
ABSTRACT
BACKGROUND/

AIMS:

Advanced primary open angle glaucoma (POAG) is a lifelong condition. The aim of this study is to compare medical treatment against trabeculectomy for patients presenting with advanced POAG using an economic evaluation decision model.

METHODS:

A Markov model was used to compare the two treatments, medical treatment versus trabeculectomy for the management of advanced POAG, in terms of costs and quality-adjusted life-years (QALYs). The uncertainty surrounding the model findings was assessed using probabilistic sensitivity analysis and deterministic analysis. Data for the model came from Treatment of Advanced Glaucoma Study supplemented with data from the literature. The main outcomes of the model presented in terms of Incremental costs and QALYs based on responses to the EQ-5D-5L, Health Utilities Index-3 and a Glaucoma Utility Index.

RESULTS:

In the base-case analysis (lifetime horizon and EQ-5D-5L measure), participants receiving trabeculectomy had on average, an additional cost of £2687, an additional 0.28 QALYs and an incremental cost per QALY of £9679 compared with medical treatment. There was a 73% likelihood of trabeculectomy being considered cost-effective when society was willing to pay £20 000 for a QALY. Over shorter time horizons, the incremental cost per QALY gained from trabeculectomy compared with medical treatment was higher (47 663) for a 2-year time horizon. Our results are robust to changes in the key assumptions and input parameters values.

CONCLUSION:

In patients presenting with advanced POAG, trabeculectomy has a higher probability of being cost-effective over a patient's lifetime compared with medical treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trabeculectomía / Glaucoma de Ángulo Abierto / Cadenas de Markov / Análisis Costo-Beneficio / Modelos Económicos / Años de Vida Ajustados por Calidad de Vida Tipo de estudio: Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Ophthalmol Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trabeculectomía / Glaucoma de Ángulo Abierto / Cadenas de Markov / Análisis Costo-Beneficio / Modelos Económicos / Años de Vida Ajustados por Calidad de Vida Tipo de estudio: Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Ophthalmol Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido