OBJECTIVES

Non-infectious uveitis affecting the posterior segment of the eye (NIU-PS) is a severe and highly recurrent condition causing vision loss and, potentially, blindness. Most patients require long-term treatment to prevent recurrences of ocular inflammation. Current local and systemic treatment options may provide insufficient inflammation control, are not well tolerated and require frequent administration. The fluocinolone acetonide (FAc; releasing 0.2µg FAc/day over 36 months) ocular implant is designed to protect ocular tissues from cumulative damage associated with recurrences of chronic inflammation and preserve vision. It is indicated for the prevention of relapse of recurrent NIU-PS.

METHODS

A cohort-based Markov model was developed to evaluate the cost-effectiveness of the FAc implant versus (Limited) Current Practice ((L)CP) in patients with NIU-PS; applying the UK list price of £5,500. Clinical inputs were derived from PS-FAV-001. Health-related quality of life was estimated from mapped VFQ-25 values reported in a separate trial. Cost and healthcare resource use was estimated from the UK perspective. A lifetime horizon was used for deterministic and probabilistic sensitivity analyses, applying a 3.5% annual discount rate for costs and benefits.

RESULTS

The model predicted a total cost per patient of £32,847.73 for the FAc implant and £30,425.45 for (L)CP, and 14.3 and 13.97 in QALYs, respectively. Patients receiving the FAc implant incurred a higher number of QALYs vs (L)CP, primarily due to a decreased number of uveitis recurrences. The deterministic ICER was £8,129 with a net monetary benefit of £3,537, demonstrating the FAc implant to be cost-effective at a willingness-to-pay threshold of £20,000/QALY under base case assumptions. Sensitivity analysis showed that results are robust and scenario analysis demonstrated that the FAc implant remains cost-effective under different structural assumptions.

CONCLUSIONS

The FAc implant is cost-effective from a UK national healthcare payer perspective.