OBJECTIVES:

Minimally invasive glaucoma surgery (MIGS) devices have the potential to address an unmet need in primary open angle glaucoma (POAG) treatment by significantly reducing patients’ intraocular pressure and medication burden without the risk profile of conventional filtration surgeries such as trabeculectomy or drainage implants. This study assessed the financial impact of the inclusion of a new supra-ciliary micro-stent for patients with mild to moderate POAG.

METHODS:

A UK national and local payer perspective budget impact model estimated the impact of including the Alcon supra-ciliary micro-stent for patients with POAG as a standalone procedure or in conjunction with cataract surgery. Published national population estimates and POAG incidence and prevalence data for adults were used to estimate patients eligible for MIGS procedures. Comparators, patient utilisation and resource use were derived from published sources, a survey of 40 practicing glaucoma/cataract specialists and interviews with two UK experts in surgical glaucoma. Published costs for the surgical glaucoma procedure, MIGS devices, post-procedure monitoring, and prescription eye drops were included to reflect the total cost of treatment. The base-case assumes that uptake increases over five years.

RESULTS:

Over five years, an estimated 762,691 patients will undergo 1,176,225 POAG and POAG/cataract procedures (including bilateral disease). Of these procedures, approximately 68,173 will involve implantation with the Alcon supra-ciliary micro-stent. Its inclusion in the POAG treatment pathway results in a neutral budget impact, given a total budget increase of only 0.63% (£10,475,789). Cost savings (£529,504, -0.12%) are expected in the concurrent POAG/cataract population. Overall, the cost of the device is offset by savings in procedure and monitoring costs compared with other MIGS devices and trabeculectomy. Univariate sensitivity analyses confirm that model results are robust.

CONCLUSIONS:

The inclusion of the Alcon supra-ciliary micro-stent is cost neutral to UK national and local payers, providing access to an innovative minimally invasive treatment for POAG.