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Prostaglandin Analogues for the Treatment of Glaucoma and Ocular Hypertension a Systematic Review of Economic Evidence Michelle Orme and Annabel Boler

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Prostaglandin Analogues for the Treatment of Glaucoma and Ocular Hypertension a Systematic Review of Economic Evidence Michelle Orme and Annabel Boler Pharmacoeconomics 2006; 24 (8): 743-750 Supplementary Material 1170-7690/06/0008-0001/$39.95/0 REVIEW ARTICLE © 2006 Adis Data Information BV. All rights reserved. Prostaglandin Analogues for the Treatment of Glaucoma and Ocular Hypertension A Systematic Review of Economic Evidence Michelle Orme and Annabel Boler Heron Evidence Development Ltd, Letchworth Garden City, UK Supplementary Material This supplementary material contains the search strategies and table referred to in the full version of this article, which can be found at http://www.adisonline.com/phe © 2006 Adis Data Information BV. All rights reserved. Pharmacoeconomics 2006; 24 (8) 2 Orme & Boler 1. Search Strategies 1.1 MEDLINE #1. exp "GLAUCOMA,-OPEN-ANGLE"/ #2. exp "GLAUCOMA"/ #3. exp "OCULAR-HYPERTENSION"/ #4. (OPEN ANGLE adj5 GLAUCOMA).mp. [mp=ti, ot, ab, nm, hw] #5. ((OCULAR adj HYPERTENSION) or OHT).mp. [mp=ti, ot, ab, nm, hw] #6. (chronic adj3 simple adj3 glaucoma).mp. [mp=ti, ot, ab, nm, hw] #7. (wide adj3 angle adj3 glaucoma).mp. [mp=ti, ot, ab, nm, hw] #8. 1 or 2 or 3 or 4 or 5 or 6 or 7 #9. (Latanoprost$ or Xalatan$ or bimatoprost$ or Lumigan$ or travoprost$ or Travatan$ or unoprostone$ or Rescula$ or Xalacom$).mp. [mp=ti, ot, ab, nm, hw] #10. prostaglandin$.mp. [mp=ti, ot, ab, nm, hw] #11. Prostaglandins F, Synthetic/ #12. 9 or 10 or 11 #13. Economics/ #14. "costs and cost analysis"/ #15. Cost allocation/ #16. Cost-benefit analysis/ #17. Cost control/ #18. Cost savings/ #19. Cost of illness/ #20. Cost sharing/ #21. "deductibles and coinsurance"/ #22. Medical savings accounts/ #23. Health care costs/ #24. Direct service costs/ #25. Drug costs/ #26. Employer health costs/ #27. Hospital costs/ #28. Health expenditures/ #29. Capital expenditures/ #30. Value of life/ #31. exp economics, hospital/ #32. exp economics, medical/ #33. Economics, nursing/ #34. Economics, pharmaceutical/ #35. exp "fees and charges"/ #36. exp budgets/ #37. (low adj cost).mp. #38. (high adj cost).mp. #39. (health?care adj cost$).mp. #40. (fiscal or funding or financial or finance).tw. #41. (cost adj estimate$).mp. #42. (cost adj variable) #43. (cost adj effectiv$).mp. #44. (cost adj utilit$).mp. #45. (cost adj benef$).mp #46. (unit adj cost$).mp. #47. (economic$ or pharmacoeconomic$ or price$ or pricing).tw. #48. or/13-47 #49. 8 and 12 and 48 © 2006 Adis Data Information BV. All rights reserved. A Review of Prostaglandin Analogues in Glaucoma 3 1.2 EMBASE #1. exp "GLAUCOMA,-OPEN-ANGLE"/ #2. exp "GLAUCOMA"/ #3. exp "OCULAR-HYPERTENSION"/ #4. (OPEN ANGLE adj5 GLAUCOMA).mp. [mp=ti, ot, ab, nm, hw] #5. ((OCULAR adj HYPERTENSION) or OHT).mp. [mp=ti, ot, ab, nm, hw] #6. (chronic adj3 simple adj3 glaucoma).mp. [mp=ti, ot, ab, nm, hw] #7. (wide adj3 angle adj3 glaucoma).mp. [mp=ti, ot, ab, nm, hw] #8. or/1-7 #9. (Latanoprost$ or Xalatan$ or bimatoprost$ or Lumigan$ or travoprost$ or Travatan$ or unoprostone$ or Rescula$ or Xalacom$).mp. [mp=ti, ot, ab, nm, hw] #10. prostaglandin$.mp. [mp=ti, ot, ab, nm, hw] #11. Prostaglandins F, Synthetic/ #12. 9 or 10 or 11 #13. Socioeconomics/ #14. Cost benefit analysis/ #15. "Cost Effectiveness Analysis"/ #16. Cost of illness/ #17. Cost control/ #18. Economic aspect/ #19. Financial management/ #20. Health care cost/ #21. Health care financing/ #22. Health economics/ #23. Hospital cost/ #24. (fiscal or financial or finance or funding).tw. #25. Cost minimization analysis/ #26. (cost adj estimate$).mp. #27. (cost adj variable$).mp. #28. (unit adj cost$).mp. #29. (cost adj effectiv$).mp. #30. (cost adj utilit$).mp. #31. (cost adj benef$).mp. #32. or/13-31 #33. 8 and 14 and 32 1.3 NHS EED #1. (latanoprost or xalatan or bimatoprost or lumigan or travoprost or travatan or unoprostone or rescula or xalacom) #2. prostaglandin* #3. or/1-2 #4. glaucoma #5. glaucoma/ #6. (ocular next hypertension) #7. or/4-6 #8. 7 and 3 © 2006 Adis Data Information BV. All rights reserved. 4 Orme & Boler 2. Review of Cost-Effectiveness Evidence Table I. Summary of included economic studies evaluating the cost-effectiveness evidence for prostaglandin analogues in the management of glaucoma and ocular hypertension Study Evaluation scope Evaluation framework Clinical outcomes Economic outcomes Key results Qualitative review (country) (disease, treatment (source) (source) and perspective) Aballea et Glaucoma; 1st-line CEA; Markov model with Months of IOP control (RCR in Cost components [€] unclear and year of ICER LAT vs BB ranged Methodology: NR al.[1] a LAT or BB; 3rd-party Monte Carlo simulation; 2y Germany, Italy, Spain and UK) costs not stated (RCR in Germany, Italy, from €24.94 (95% CI Transparency: NR (Austria, payer timeframe Spain and UK; data for Austria, Belgium and 20.68, 30.11) per IOP- Sensitivity: NR Belgium, France generalised from this RCR) controlled month for Relevance: + France France to €272.84 (95% Overall score: NR Germany, CI 251.24, 297.17) for Italy, UK) Germany Bernard et OHT or CEA; decision-analytical IOP-controlled days based on Cost components [€, 2002 values]: Total cost (3y): Methodology: + al.[2] OAG/treatment-naive model and Monte Carlo persistence data. Therapy medication, visits and surgery (2y European LAT €868.28 (SD Transparency: + (France) pts; 1st-line BB or simulation (10 000 pts per switch is assumed to imply RCR) 203.31), Sensitivity: ± LAT (0.005%) arm); 24mo and 36mo therapy failure (unpublished 2y Unit costs: Vidal, UNCANSS, PMSI BB €842.46 (SD 343.10) Relevance: + monotherapy, usual timeframe from start of RCR in UK, Italy, Germany and Incremental cost per day Overall score: + care for pts who monotherapy Spain) of IOP control of LAT vs switch therapy; 3rd- BB: €0.82 over 2y, €0.36 party payer direct over 3y costs (NHI) Day et al.[3] OHT or OAG in CCA; RCR; 6mo timeframe Persistence [days on treatment] Cost components [$US, 2001 values]: At 6mo, BIM and BB- Methodology: ± (US) previously treated or from initiation of study and IOP (RCR from several glaucoma and other drugs, visits and treated pts had Transparency: − treatment-naive pts; monotherapy large glaucoma US practices) procedures, treatment of AEs – additional significantly higher IOPs Sensitivity: − LAT (0.005%) vs BIM visits and tests (RCR) (p < 0.0001) and lower Relevance: ± (0.03%) vs BB Drugs unit cost: AWP persistency (p < 0.0008) Overall score: − monotherapy; 3rd- Visits and procedures cost: Blue Cross and than LAT party payer direct Blue Shield insurer schedules Total cost (SD): costs LAT $US153.7 (46.7); BIM $US163.8 (51.2); BB $US119.3 (78.9) Doyle et Glaucoma; BIM CEA; model not described; % of pts with target IOP levels Cost components [$US]: glaucoma drugs Incremental cost per Methodology: NR al.[4] a (US) (0.03%), combination 3mo timeframe <17mm Hg (3mo RCT) only (3mo RCT) additional treatment Transparency: NR product TIM Unit costs: AWP success with BIM Sensitivity: NR 0.5%/DOR 2%; Year of costs not stated $US214 Relevance: − pharmacy direct costs Overall score: NR (drugs only) Continued next page © 2006 Adis Data Information BV. All rights reserved. Pharmacoeconomics 2006; 24 (8) A Review of Prostaglandin Analogues in Glaucoma 5 Table I. Summary of included economic studies evaluating the cost-effectiveness evidence for prostaglandin analogues in the management of glaucoma and ocular hypertension Study Evaluation scope Evaluation framework Clinical outcomes Economic outcomes Key results Qualitative review (country) (disease, treatment (source) (source) and perspective) Evans et Glaucoma; BIM CEA; model; timeframe: % of pts with target IOP Cost components [€]: medication and visits Average expected costs: Methodology: − al.[5] a (0.03%)orTIM costs over 12mo, <17mm Hg for all measurements (unclear) €485 (BIM) vs €471 Transparency: NR (country 0.5%/DOR 2%; 3rd- effectiveness over 3mo throughout day (RCT with 3mo Year of costs not stated (TIM/DOR) Sensitivity: NR unclear) party payer direct follow-up) Cost per pt reaching IOP Relevance: − costs target at 3mo = €139 Overall score: NR (BIM) vs €190 (TIM/DOR) Fiscella et Glaucoma; BB, CAI, CA; cost identification study; NA Total no. of drops per bottle measured to Daily costs: Methodology: − al.[6] (US) BRI, PAs; pharmacy timeframe not specified calculate daily cost (AWP; $US, 2002 BB $US0.38–1.08, Transparency: + direct costs (drugs values) CAI $US1.05–1.33, Sensitivity: − only) PAs $US0.90–1.25, Relevance: − BRI $US1.29 Overall score: − Gosden et POAG; 1st-line LAT, CEA; decision-analytical Days of IOP control estimated Cost components [£, 2003 values]: For a cohort of 1000 pts, Methodology: NR al.[7] a (UK) BB, TRA or BIM; NHS model over 1y by assuming switching therapy consultations, drug usage and glaucoma LAT results in 10 397, Transparency: NR direct costs implies failure to control IOP for surgery (expert opinion) 14 341 and 17 142 more Sensitivity: NR half the time on treatment days of IOP control vs Relevance: + (persistency data[8]) BB, TRA and BIM, Overall score: NR respectively Treatment costs (vs LAT): £29 597 more with TRA; £36 650 more with BIM Halpern et OAG or OHT in Black CCA; extrapolation IOP and VFD scores (combined Estimated effects of VFD change on cost Mean additional annual Methodology: − al.[9] (US) subjects; TRA model/unclear; 12mo six published algorithms linking [inflated to $US, 2000 values] of cost: Transparency: − (0.004%), timeframe IOP and VFD progression with hospitalisation and outpatient care LAT vs TRA 0.004%, Sensitivity: − TRA (0.0015%), data from a subgroup of 132 (hospitalisations: Morse et al.,[11] 1996 $US170 (SD 69, range Relevance: − LAT (0.005%), Black pts included in a trial of National Health Interview Survey,[12] 70–263); Overall score: − TIM (0.5%); 3rd-party 596 pts[10]) Medicare cost schedule 1995) TIM vs TRA 0.004%, payer direct costs Outpatient costs: estimated from guidelines $US247 (SD 112, range (Medicare) – Preferred Practice Patterns of the AAO 66–365) 1996 Continued next page © 2006 Adis Data Information BV.
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