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Abstract
Aim
To evaluate the cost-effectiveness (CE) and budget impact (BI) of introducing a patient visit support system (ACT Pack) along with standard of care (SoC), in glaucoma treatment in Japan.
Methods
A Markov model was designed to estimate the CE and BI of introducing the support system from Japanese payer and governmental perspective, respectively. Inputted data for CE and BI analysis were referred from published literature and based on medical specialists’ inputs. Base case scenario for CE considered the support system cost of 30,000 yen per patient per year and a time horizon of 45 years. BI analysis compared the financial impact due to introduction of support system with SoC compared to SoC alone scenario on Japanese healthcare system with a time horizon of 20 years.
Results
The base case of CE analysis showed the incremental cost per quality-adjusted life years (QALYs) gained with the support system was 3,241,729 yen/QALY (29,470 USD/QALY). The sensitivity analysis showed that the probability of this support system being cost-effective at a threshold of 5 million yen/QALY (45,455 USD/QALY) was 53.26%. Blindness reduction after introduction of this support system was 8.68%. The BI analysis showed that the introduction of support system will lead to a cumulative cost savings of 1,132 billion yen (10 billion US dollars) for Japanese healthcare system over 20 years of time horizon.
Limitation
Due to paucity of similar comparative studies, some assumptions were made based on medical specialists’ inputs. Death status was not considered in the analysis.
Conclusion
Introduction of this support system with SoC is cost-effective and will lead to blindness reduction in Japanese patients with glaucoma. Over a 20 year period, it will lead to an overall cost savings of 1,132 billion yen (10 billion US dollars) for the Japanese healthcare system.
Transparency
Declaration of funding
Sponsorship and article processing charges for this study were funded by Santen Pharmaceutical Co., Ltd., Osaka, Japan.
Declaration of financial/other interests
MY and TN have received lecture fees from Santen Pharmaceutical Co., Ltd. and are advisors of Santen Pharmaceutical Co., Ltd.
YT is an employee of Santen Pharmaceutical Co., Ltd.
The peer reviewers on this manuscript have received an honorarium from JME for their review work. In addition, a reviewer on this manuscript has disclosed that they have a financial interest in Glaukos (In 2019 it was announced that Santen’s U.S. subsidiary, Santen Inc., entered into a multi-year agreement whereby Glaukos will become the exclusive distributor of the MicroShunt solely in the U.S. market. This agreement does not represent an agreement outside the US. This study was sponsored by Santen Inc). The reviewers have no other relevant financial relationships or otherwise to disclose.
Author contributions
All named authors meet the ICMJE criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for this version to be published.
MY, TN, and YT conceived and designed the study and constructed the model and reviewed the manuscript. HM, and SWK reviewed the model and analyzed the data.
HM, SWK, and YT wrote the manuscript.
Acknowledgements
The medical writing for the manuscript was supported by Yukti Singh and Pragya Rai from IQVIA, India.