OBJECTIVES : Dry eye disease (DED) is a common ophthalmic disorder, with a prevalence of ranging from 5–33% globally and a substantial economic burden. A budget impact model was developed to estimate the impact of introducing cyclosporine ophthalmic solution 0.09% for the treatment of DED from the perspective of a US health plan.

METHODS : Pharmacy costs before and after the introduction of cyclosporine ophthalmic solution 0.09% were assessed for a health plan of one million members over 5 years. Comparators were FDA-approved treatments for DED, including cyclosporine ophthalmic emulsion 0.05% unit dose, cyclosporine ophthalmic emulsion 0.05% multidose, and lifitegrast ophthalmic solution 5%. The target population consisted of adult patients diagnosed with DED who were prescribed any of these 3 medications. Prevalence was sourced from published literature and US Census data. Pharmacy costs were measured using the 2018 wholesale acquisition costs. The incremental annual health plan, per member per year (PMPY), and per member per month (PMPM) costs were assessed in $2018, assuming a 1% annual increase in the uptake of cyclosporine ophthalmic solution 0.09%.

RESULTS : The model projected that 7,358 members in a commercial plan and 21,259 members in a Medicare plan would be treated for DED annually. After the introduction of cyclosporine ophthalmic solution 0.09%, costs to a commercial payer decreased by $1,699, $3,398, $5,097, $6,796, and $8,495 in Years 1 through 5, respectively, leading to a total cost reduction of $25,485. For a Medicare payer, the total cost decreased by $73,629 over 5 years ($4,909, $9,817, $14,726, $19,634, and $24,543 in Years 1 to 5, respectively). The incremental, annual PMPY and PMPM costs were negligible for both commercial and Medicare payers.

CONCLUSIONS : Introduction of cyclosporine ophthalmic solution 0.09% into formularies for the treatment of DED may reduce the pharmacy costs of commercial and Medicare health plans.