Cost-Utility Analysis of a Medication Adherence-Enhancing Educational Intervention for Glaucoma
Published by Elsevier Inc..
OBJECTIVE: To evaluate the cost utility of a glaucoma medication-enhancing intervention compared to standard of care over a lifetime from the United States Department of Veterans Affairs (VA) payer perspective.
DESIGN: Model-based cost-utility analysis of a glaucoma medication-enhancing intervention from a randomized clinical trial.
SUBJECTS: Veterans with glaucoma, or suspected glaucoma who were prescribed topical glaucoma medications, had their visual field assessed within the last 9 months, and endorsed poor glaucoma medication adherence.
METHODS: Veterans were randomized either to a behavioral intervention to promote adherence or to a standard of care (control) session about general eye health. A decision analytic model was developed to simulate lifelong costs and quality-adjusted life years (QALYs) for an intervention tested in a randomized clinical trial at a single VA eye clinic. Costs included direct medical costs that the VA payer would incur, as informed initially by the clinical trial and then by published estimates. Health-state quality of life was based on published utility values. Scenario analyses included addition of booster interventions, a 3% decline in chance of staying medication adherent annually, and the combination of the two. Analyses were also conducted in the following subgroups: those with companion versus not, and those with once-daily versus more than once-daily dosing frequency.
MAIN OUTCOME MEASURES: Incremental cost-effectiveness ratio (ICER).
RESULTS: Compared to standard of care, the intervention dominated resulting in lower costs ($23 339.28 versus $23 504.02) and higher QALYs (11.62 versus 11.58). Among the 4 subgroups, the intervention dominated for 3 of them. In the fourth subgroup, those with more than once-daily dosing, the ICER was $2625/QALY. Compared to standard of care, an intervention with booster interventions led to an ICER of $3278/QALY. Assuming both a 3% annual loss in chance of continuing to be adherent and addition of booster interventions, the ICER increased to $71 371/QALY.
CONCLUSIONS: From a VA payer perspective over a lifetime, the glaucoma medication-enhancing behavioral intervention dominated standard of care in terms of generating cost savings and greater QALYs.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found after the references.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
Ophthalmology. Glaucoma - 6(2023), 4 vom: 01. Juli, Seite 395-404 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hung, Anna [VerfasserIn] |
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| Links: |
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| Themen: |
Cost-effectiveness, Glaucoma, Medication adherence |
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| Anmerkungen: |
Date Completed 02.11.2023 Date Revised 02.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ogla.2023.01.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352174978 |
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| 245 | 1 | 0 | |a Cost-Utility Analysis of a Medication Adherence-Enhancing Educational Intervention for Glaucoma |
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| 500 | |a Date Revised 02.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Elsevier Inc. | ||
| 520 | |a OBJECTIVE: To evaluate the cost utility of a glaucoma medication-enhancing intervention compared to standard of care over a lifetime from the United States Department of Veterans Affairs (VA) payer perspective | ||
| 520 | |a DESIGN: Model-based cost-utility analysis of a glaucoma medication-enhancing intervention from a randomized clinical trial | ||
| 520 | |a SUBJECTS: Veterans with glaucoma, or suspected glaucoma who were prescribed topical glaucoma medications, had their visual field assessed within the last 9 months, and endorsed poor glaucoma medication adherence | ||
| 520 | |a METHODS: Veterans were randomized either to a behavioral intervention to promote adherence or to a standard of care (control) session about general eye health. A decision analytic model was developed to simulate lifelong costs and quality-adjusted life years (QALYs) for an intervention tested in a randomized clinical trial at a single VA eye clinic. Costs included direct medical costs that the VA payer would incur, as informed initially by the clinical trial and then by published estimates. Health-state quality of life was based on published utility values. Scenario analyses included addition of booster interventions, a 3% decline in chance of staying medication adherent annually, and the combination of the two. Analyses were also conducted in the following subgroups: those with companion versus not, and those with once-daily versus more than once-daily dosing frequency | ||
| 520 | |a MAIN OUTCOME MEASURES: Incremental cost-effectiveness ratio (ICER) | ||
| 520 | |a RESULTS: Compared to standard of care, the intervention dominated resulting in lower costs ($23 339.28 versus $23 504.02) and higher QALYs (11.62 versus 11.58). Among the 4 subgroups, the intervention dominated for 3 of them. In the fourth subgroup, those with more than once-daily dosing, the ICER was $2625/QALY. Compared to standard of care, an intervention with booster interventions led to an ICER of $3278/QALY. Assuming both a 3% annual loss in chance of continuing to be adherent and addition of booster interventions, the ICER increased to $71 371/QALY | ||
| 520 | |a CONCLUSIONS: From a VA payer perspective over a lifetime, the glaucoma medication-enhancing behavioral intervention dominated standard of care in terms of generating cost savings and greater QALYs | ||
| 520 | |a FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found after the references | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cost-effectiveness, Glaucoma, Medication adherence | |
| 700 | 1 | |a Williams, Andrew M |e verfasserin |4 aut | |
| 700 | 1 | |a Newman-Casey, Paula Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Muir, Kelly W |e verfasserin |4 aut | |
| 700 | 1 | |a Gatwood, Justin |e verfasserin |4 aut | |
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