Modelling the lifetime economic consequences of glaucoma in France

Abstract

Objective: To estimate the lifetime economic consequences of glaucoma in France.

Methods: A Markov model estimated the average discounted outcome and cost of glaucoma treatment over a patient's lifetime. Clinical states were defined as first- to fourth-line drugs, no treatment, laser therapy, surgery, blindness and death. After each failure (always after the fourth-line drug) patients could receive either laser treatment or surgery followed by no treatment, or a new treatment. A societal perspective was adopted. Sensitivity analyses were performed.

Results: Discounted medical costs were €7,322 for ocular hypertension treatment (OHT) and €8,488 for a glaucoma patient. Social costs of OHT and glaucoma patients exceeded medical costs. First-line use of the most effective drug would reduce medical and social costs. Societal willingness to pay for the vision benefit would equal the medical costs. Treatment initiated with the most effective drug is a cost saving strategy.

Conclusions: Public health decisions in glaucoma treatment should take a broad economic view embracing the lifetime duration of the disease. There is still a place both within and outside the healthcare system for therapeutic innovations with important economic consequences that bring high added value to patients.

Key words::

• economics
• glaucoma
• life-long treatment
• model

Acknowledgement

The survey was supported by an unrestricted grant from Alcon France SA, Rueil-Malmaison, France, was conducted according to local laws and was contracted to Cemka, Bourg-la-Reine, France.