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The following is a summary of “Is primary trabeculectomy cost-effective for patients with advanced primary open angle glaucoma? Results from the Treatment of Advanced Glaucoma Study economic model,” published in the February 2024 issue of Ophthalmology by Shabaninejad et al.
Primary open-angle glaucoma (POAG) is a chronic condition that persists throughout a patient’s lifetime.
Researchers conducted a retrospective study to assess the economic viability of medical treatment versus trabeculectomy in patients with advanced POAG through a decision model analysis.
They utilized a Markov model to compare medical treatment and trabeculectomy for advanced POAG, assessing costs and quality-adjusted life-years (QALYs). Uncertainty was evaluated through probabilistic and deterministic analyses, with data from the Treatment of Advanced Glaucoma Study and additional literature. The primary outcomes, including incremental costs and QALYs, were based on EQ-5D-5L, Health Utilities Index-3, and a Glaucoma Utility Index.
The result showed that in the base-case analysis (lifetime horizon and EQ-5D-5L measure), individuals undergoing trabeculectomy incurred an additional cost of £2,687, gained a further 0.28 QALYs, and had an incremental cost per QALY of £9,679 compared to medical treatment. Trabeculectomy had a 73% likelihood of being considered cost-effective when society paid £20,000 for a QALY. Over shorter time horizons, the incremental cost per QALY gained from trabeculectomy compared to medical treatment was higher (£47,663) for a 2-year period. The results remained robust to changes in key assumptions and input parameter values.
Investigators concluded that for advanced POAG patients, trabeculectomy surgery offers a strong chance of being more cost-effective over their lifetime compared to continued medical treatment alone.
Source: bjo.bmj.com/content/early/2024/02/09/bjo-2023-323390