OBJECTIVES:

OMNI^® Surgical System has demonstrated in clinical trials a reduction in intraocular pressure (IOP) both as a standalone procedure or combined with cataract surgery in eyes with mild to moderate primary open-angle glaucoma (POAG). Clinical data on efficacy and safety of OMNI Surgical System are published in the literature; however, the cost-effectiveness of OMNI Surgical System has not been studied. The objective of this analysis is to estimate the cost-effectiveness of the OMNI Surgical System versus iStent Inject for the treatment of primary open-angle glaucoma (POAG) in combination with cataract surgery.

METHODS:

A cost-effectiveness model was developed in Microsoft Excel using a Medicare perspective with a lifetime time horizon with a 6-month Markov cycle based on typical treatment monitoring. In this model, the only comparator was the iStent Inject, and the population included patients with mild to moderate POAG. Health states were defined by POAG severity (mild, moderate, advanced, severe) and death. Model outcomes included total quality-adjusted life-years (QALYs), total health care costs, and incremental cost-effectiveness ratio (ICER).

RESULTS:

Total costs and QALYs were $11,178 and 8.50 for OMNI Surgical System vs. $12,093 and 8.898 for iStent inject. OMNI Surgical System reduced health care costs by $915 with an incremental benefit of 0.052 QALYs when compared with iStent Inject across a lifetime period. The main driver was a reduction in health care costs, both medications and post-surgical procedure costs, related with a slowed progression to advanced/severe status. Moreover, for the OMNI Surgical System, a surgical re-intervention related to device complications is not necessary (while for iStent the assumption, based on literature, is that it occurs in <3% of patients).

CONCLUSIONS:

OMNI Surgical System for the treatment of mild to moderate POAG in combination with cataract surgery is clinically superior based on QALY gains and cost-saving compared to iStent Inject.