[PAE11] Economic evaluation of latanoprost as first line glaucoma therapy in 6 European countries

[PAE11] Economic evaluation of latanoprost as first line glaucoma therapy in 6 European countries

2003 Value in health

Aballea, S. | Martin, M. | Bernard, L. | Althin, R. | Volume: 6, Issue: 6, Pages: 639, therapy, economic evaluation,

OBJECTIVE: The aim of glaucoma treatment is to delay
progression of the disease to blindness, by lowering
intra-ocular pressure (IOP). Clinical trials have shown
that latanoprost (Xalatan®, Pfizer) achieves better IOP
control than beta-blockers. We assessed the costeffectiveness
of latanoprost as 1st-line therapy, compared
to beta-blockers, in Austria, Belgium, France, Germany,
Italy and the UK. METHODS: Clinical outcomes and
resource utilisation data were obtained from a retrospective
chart review study of glaucoma patients initially
treated with latanoprost or beta-blocker in Germany,
Italy, Spain, and the UK. A Markov model was used to
calculate the number of months of IOP control and total
costs (including drugs, physician visits, diagnostic tests
and surgeries) per patient over 2 years from a third-party
payer perspective. The model was estimated by Monte
Carlo simulation. The incremental cost per IOPcontrolled
month was reported for each country and
variability around this ratio was examined. RESULTS:
Seventy-three percent of patients remained on treatment
with latanoprost, compared to 29% with beta-blocker,
over 2 years. The higher acquisition cost of latanoprost
was partly offset by lower surgery costs. The ICER ranged
from €24.94 (95% CI: 20.68-30.11) per IOP-controlled
month, for France, to €272.84 (251.24-297.17), for
Germany. Sensitivity analyses showed that survival on
therapy, the duration of medication bottles and parameters
related to surgery costs were the main drivers of
cost-effectiveness. CONCLUSIONS: Differences between
countries were mainly attributable to variation in drug
and surgery unit costs. First-line treatment with
latanoprost is predicted to be cost-effective if decisionmakers
value the control of IOP at a minimum of approximately
€25 per month in France, €45 per month in
Belgium, UK and €275 per month in Germany, under the
current system and costs of care. Relatively low unit costs
for surgery and the drug co-payment system contributed
to the higher ICER in Germany.