OBJECTIVES:

Minimally Invasive Glaucoma Surgery (MIGS) devices fill an unmet need in therapy between topical pharmacological medicines and more invasive filtration procedures. This study evaluates the budget impact of using a new supra-ciliary microstent (Alcon Laboratories) device in Spanish hospitals as a stand-alone procedure or in conjunction with cataract surgery primary open angle glaucoma (POAG) patients where previous treatments have failed.

METHODS:

A budget impact model (BIM) from a Spanish hospital outpatient perspective was developed using Microsoft® Excel®. Population and cost estimates were derived from published sources. POAG disease characteristics were obtained from the literature and an online survey of 40 practicing glaucoma/cataract specialists in Spain. Comparators and market share data were obtained from independent market research. Resource use assumptions associated with each intervention were obtained through survey results and from interviews with four key opinion leaders. Costs included published device costs, post-procedure follow-up care, and facility costs.

RESULTS:

An estimated 227,248 trabeculectomy, laser assisted trabeculoplasty or MIGS POAG interventions will occur over five years, 21,452 of which will use supra-ciliary microstent. The use of supra-ciliary microstent will have a low budget impact of 5.3% in the first year (€1,116,370) and an average budget impact of 8.2% over five years, with cost increases primarily driven by patients shifting from lower cost laser trabeculoplasty procedures. However, total intervention costs for supra-ciliary microstent (€1774) are lower than total intervention costs for the other included MIGS procedures (trabecular micro-bypass generation 1: €1829; subconjunctival gelatin stent: €2744) and similar to the common, but invasive trabeculectomy surgery (€1762). MS cost offsets were driven by decreases in procedure-related resource use and post-procedure follow-up care. Univariate sensitivity analyses confirm that model results are robust.

CONCLUSIONS:

The introduction of supra-ciliary microstent will have a minimal budget impact in Spain while increasing access to a valuable, minimally invasive treatment alternative for glaucoma.