Budget impact analysis of the XEN® gel stent implant for glaucoma treatment

ABSTRACT

Objective: To determine the economic impact of the XEN® Gel Stent implant inclusion into the therapeutic arsenal for surgical treatment of open-angle glaucoma in Spain.

Methods: A budget-impact analysis was designed to estimate the costs of surgical intervention in patients with not-controlled glaucoma from the perspective of the Spanish National Health System (NHS).

A hypothetical cohort (135 patients with glaucoma) was analyzed and subdivided into three subgroups considering the appropriate interventions: cataracts, iStent®+cataracts, ExPRESS®±cataracts, trabeculectomy±cataracts, and non-penetrating deep sclerectomy (NPDS)±cataracts.

The current scenario was compared along a 3-years, with a future scenario considering XEN® for mild glaucoma+cataracts cases (3%) and moderate glaucoma+cataracts and glaucoma without cataracts cases; 30% (year 1), 35% (year 2) and 40% (year 3).

The estimation of total cost (€,2016) included the following components: device costs, surgical interventions, follow-up visits, complications management, and additional procedures costs.

An expert panel provided proportions of use and resource consumption for each intervention. Unitary costs derived from a national database.

Results: The current cost for surgical treatment of glaucoma resulted €4,665.41/patient. The inclusion of the XEN® implant would generate savings of €465.24 in year 1 and €618.82 (years 2–3).

Conclusion: XEN® implant inclusion for surgical treatment of glaucoma would result in cost-savings for the NHS.

KEYWORDS:

• budget impact analysis
• MIGS
• glaucoma
• cataracts
• surgery

Declaration of interest

A. Amaro-Barra and I. Oyagüez are employed by PORIB, a consultant company specialized in the economic evaluation of health interventions which has received financial support for the development of the model design, the analysis, and drafting of the manuscript. J.M. Martínez-de-la-Casa, M.A. Teus, and J. Vila-Arteaga have received honoraria from Allergan for consultancy. C. Martínez is employed by Allergan. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work has carried-out with unrestricted financial support provided by Allergan S.A., Spain.