OBJECTIVE: To determine the most cost-effective treatment option for patients with newly diagnosed mild open-angle glaucoma: observation only, treatment with generic topical prostaglandin analogs (PGAs), or treatment with laser trabeculoplasty (LTP). METHODS: Using a Markov model with a 25-year horizon, we compared the incremental cost-effectiveness of treating newly diagnosed mild open-angle glaucoma with PGAs, LTP, or observation only. RESULTS: The incremental cost-effectiveness of LTP over no treatment is $16,824 per quality-adjusted life year. By comparison, the incremental cost-effectiveness of PGAs over no treatment is $14,179 per quality-adjusted life year, and they provide greater health-related quality of life relative to LTP. If PGAs are 25% less effective owing to poor patient adherence, LTP can confer greater value. CONCLUSIONS: Prostaglandin analogs and LTP are both cost-effective options for the management of newly diagnosed mild open-angle glaucoma. Assuming optimal medication adherence, PGAs confer greater value compared with LTP. However, when assuming more realistic levels of medication adherence (making them 25% less effective than the documented effectiveness reported in clinical trials), at current prices for PGAs, LTP may be a more cost-effective alternative.
OBJECTIVE: To determine the most cost-effective treatment option for patients with newly diagnosed mild open-angle glaucoma: observation only, treatment with generic topical prostaglandin analogs (PGAs), or treatment with laser trabeculoplasty (LTP). METHODS: Using a Markov model with a 25-year horizon, we compared the incremental cost-effectiveness of treating newly diagnosed mild open-angle glaucoma with PGAs, LTP, or observation only. RESULTS: The incremental cost-effectiveness of LTP over no treatment is $16,824 per quality-adjusted life year. By comparison, the incremental cost-effectiveness of PGAs over no treatment is $14,179 per quality-adjusted life year, and they provide greater health-related quality of life relative to LTP. If PGAs are 25% less effective owing to poor patient adherence, LTP can confer greater value. CONCLUSIONS:Prostaglandin analogs and LTP are both cost-effective options for the management of newly diagnosed mild open-angle glaucoma. Assuming optimal medication adherence, PGAs confer greater value compared with LTP. However, when assuming more realistic levels of medication adherence (making them 25% less effective than the documented effectiveness reported in clinical trials), at current prices for PGAs, LTP may be a more cost-effective alternative.
Authors: Henry D Jampel; Arthur Schwartz; Irvin Pollack; Donald Abrams; Howard Weiss; Rhonda Miller Journal: J Glaucoma Date: 2002-04 Impact factor: 2.503
Authors: Gemma C M Rossi; Gian Maria Pasinetti; Luigia Scudeller; Rosella Radaelli; Paolo Emilio Bianchi Journal: Eur J Ophthalmol Date: 2011 Jul-Aug Impact factor: 2.597
Authors: Michael A Kass; Dale K Heuer; Eve J Higginbotham; Chris A Johnson; John L Keltner; J Philip Miller; Richard K Parrish; M Roy Wilson; Mae O Gordon Journal: Arch Ophthalmol Date: 2002-06
Authors: M Roy Wilson; Omofolasade Kosoko; Claude L Cowan; Pamela A Sample; Chris A Johnson; Gleb Haynatzki; Cheryl Enger; David Crandall Journal: Am J Ophthalmol Date: 2002-09 Impact factor: 5.258
Authors: Peter Y Zhao; Raheem Rahmathullah; Brian C Stagg; Faisal Almobarak; Deepak P Edward; Alan L Robin; Joshua D Stein Journal: JAMA Ophthalmol Date: 2018-11-01 Impact factor: 7.389
Authors: Joshua D Stein; Paula Anne Newman-Casey; David D Kim; Kristen Harris Nwanyanwu; Mark W Johnson; David W Hutton Journal: Ophthalmology Date: 2013-05-01 Impact factor: 12.079
Authors: Ta C Chang; Richard K Parrish; Danielle Fujino; Scott P Kelly; Elizabeth A Vanner Journal: Am J Ophthalmol Date: 2020-10-10 Impact factor: 5.258