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Cost-Utility Analysis of Glaucoma Medication Adherence.
Paula Anne Newman-Casey1, Mariam Salman1, Paul P Lee1
1Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
Ophthalmology
|November 27, 2019
Summary
Improving glaucoma medication adherence is cost-effective. Nonadherent patients face earlier blindness and higher long-term costs, despite lower initial treatment expenses. Investing in adherence programs offers significant value.
Area of Science:
- Ophthalmology
- Health Economics
- Public Health
Background:
- Glaucoma medication nonadherence is prevalent, impacting disease progression and treatment outcomes.
- Estimating the cost-utility of adherence interventions is crucial for effective healthcare strategies.
Purpose of the Study:
- To evaluate the cost-utility of adherence to prescribed glaucoma medications.
- To quantify the economic impact of medication adherence on glaucoma patients.
Main Methods:
- A Monte Carlo microsimulation model with Markov cycles was employed for cost-utility analysis.
- The model incorporated data from UK Glaucoma Treatment Study, Glaucoma Laser Trial, and Tube versus Trabeculectomy Studies.
- Health states transitioned from mild to severe glaucoma, including unilateral and bilateral blindness, with associated costs and quality-adjusted life years (QALYs) calculated.
Main Results:
- Nonadherent patients experienced single-eye blindness earlier (19 years) compared to adherent patients (23 years).
- Adherent patients incurred higher total healthcare costs ($62,782) versus nonadherent patients ($52,722).
- Nonadherence resulted in a loss of 0.34 QALYs, with a cost-effectiveness ratio of $29,600 per QALY gained for adherence.
Conclusions:
- Improving glaucoma medication adherence is cost-effective, with a ratio below the $50,000/QALY willingness-to-pay threshold.
- Expanding services to enhance patient adherence is recommended.
- Interventions promoting adherence can mitigate disease progression and improve patient outcomes.
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