An economic analysis of selective laser trabeculoplasty versus topical prostaglandin analogues as initial therapy for primary open-angle glaucoma in a tertiary government hospital in the Philippines
- Author:
James Michael D. Jacomina, MD
1
;
ohn Mark S. de Leon, MD
1
;
Jose Maria D. Martinez, MD-MBA
1
Author Information
- Publication Type:Journal Article
- Keywords: cost-effectivenes; selective laser trabeculoplasty
- MeSH: Economic analysis; cost-utility; glaucoma; prostaglandin analogues; quality adjusted life years; Philippines
- From: Philippine Journal of Ophthalmology 2023;48(1):4-9
- CountryPhilippines
- Language:English
-
Abstract:
Objective: This study compared the economic viability of initial medical therapy with topical prostaglandin analogues (PGAs) versus selective laser trabeculoplasty (SLT) in the treatment of primary open-angle glaucoma (POAG).
Method:This was an economic analysis using actual, current treatment costs of PGA therapy versus SLT applied to theoretical, literature-derived clinical efficacy data projected for a period of 19 years. A socioeconomic and demographic survey conducted among POAG patients at the Department of Health Eye Center of the East Avenue Medical Center from March-April 2022 provided the economic context and setting for the analysis. The treatment regimens were compared in terms of total cost, clinical efficacy, cost-effectiveness and cost-utility in the setting of a tertiary government hospital.
Results:Thirty-one (31) patients were included in the study. The total annual cost of topical PGAs was Philippine Pesos (Php) 13,532 versus Php 6,195 for SLT. Cost-effectiveness was Php 1,933 for PGAs/mmHg reduction in intraocular pressure (IOP) versus Php 983 for SLT. Cost-utility was Php 59,793/Quality Adjusted Life Years (QALY) gained for PGAs versus Php 27,373/QALY gained for SLT projected for 19 years. With government insurance coverage, cost-utility ratio was Php 47,831/QALY gained for topical PGAs versus 16,327/QALY gained for SLT.
Conclusion:In POAG patients, SLT was more cost-effective versus PGAs with a lower cost per mmHg IOP reduction, and lower cost-utility ratio for every QALY gained. SLT can be recommended as initial therapy for POAG especially for patients being treated at tertiary government hospitals. - Full text:002-ORIGINAL-RESEARCH_PJO-JAN-JUN2023-JACOMINA_4-9_V2.pdf
