iStent inject? and cataract surgery for mild-to-moderate primary open angle glaucoma in Japan: a cost-utility analysis  

作　　者：Ataru Igarashi Kyoko Ishida Nobuyuki Shoji Alice Chu Heather Falvey Ru Han Maki Ueyama Yoshie Onishi 

机构地区：[1]Unit of Public Health and Preventive Medicine,Yokohama City University School of Medicine,Yokohama 236-0027,Japan [2]Ohashi Medical Center,Toho University,Tokyo 153-8515,Japan [3]Department of Ophthalmology,Kitasato University Hospital,Kanagawa 252-0375,Japan [4]Market Access and Medical Marketing,Glaukos Singapore,Singapore 068896,Singapore [5]Global Health Economics,Glaukos Corp,California 92672,USA [6]Health Economics and Outcomes Research,Creativ-Ceutical,Paris 75008,France [7]Health Economics and Outcomes Research,Creativ-Ceutical,Tokyo 108-6028,Japan

出　　处：《International Journal of Ophthalmology(English edition)》2022年第6期954-961,共8页国际眼科杂志（英文版）

基　　金：Glaukos Corporation for funding the study。

摘　　要：AIM: To evaluate the cost-utility of iStent inject;with cataract surgery vs cataract surgery alone in patients with mild-to-moderate primary open angle glaucoma(POAG) in the Japanese setting from a public payer’s perspective.METHODS: A Markov model was adapted to estimate the cost-utility of iStent inject;plus cataract surgery vs cataract surgery alone in one eye in patients with mild-tomoderate POAG over lifetime horizon from the perspective of Japanese public payer. Japanese sources were used for patients’ characteristics, clinical data, utility, and costs whenever available. Non-Japanese data were validated by Japanese clinical experts. RESULTS: In the probabilistic base case analysis, iStent inject;with cataract surgery was found to be cost-effective compared with cataract surgery alone over a lifetime horizon when using the ￥5 000 000/quality-adjusted life year(QALY)willingness-to-pay threshold. The incremental cost-utility ratio(ICUR) was estimated to be ￥1 430 647/QALY gained and the incremental cost-utility ratio(ICER) was estimated to be ￥12 845 154/blind eye avoided. iStent inject;with cataract surgery vs cataract surgery alone was found to increase costs(￥1 025 785 vs ￥933 759, respectively) but was more effective in increasing QALYs(12.80 vs 12.74) and avoiding blinded eyes(0.133 vs 0.141). The differences in costs were mainly driven by costs of primary surgery(￥279 903 vs ￥121 349). In the scenario analysis from a societal perspective, which included caregiver burden, iStent inject;with cataract surgery was found to dominate cataract surgery alone.CONCLUSION: The iStent inject;with cataract surgery is a cost-effective strategy over cataract surgery alone from the public payer’s perspective and cost-saving from the societal perspective in patients with mild-to-moderate POAG in Japan.

关 键 词：iStent inject? GLAUCOMA cataract surgery health-economic model COST-UTILITY 

分 类 号：R779.6[医药卫生—眼科]