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- Title
Custo-efetividade do uso do dispositivo de by-pass trabecular (iStent® Trabecular Micro- Bypass) associado a cirurgia de catarata para o tratamento conjunto do glaucoma primário de ângulo aberto e da catarata sob a perspectiva do Sistema de Saúde Suplementar no Brasil.
- Authors
Paletta Guedes, Ricardo Augusto; Pepe, Camila; Teich, Vanessa; Marcelo Gravina, Daniela; Paletta Guedes, Vanessa Maria; Chaoubah, Alfredo
- Abstract
Objective: To evaluate whether the incorporation of the iStent® Trabecular Micro-Bypass implant is cost-effective for the treatment of primary open-angle glaucoma (POAG) in patients undergoing cataract surgery from the perspective of the supplementary healthcare system in Brazil. Methods: An analytical Markov model was developed and costs were obtained from the Brazilian supplementary health perspective (direct medical costs). Effectiveness was measured in "progression free life years (PFLY)". The time horizon was the average life expectancy of the Brazilian population. Data were obtained through review and critical analysis of the literature. The base case was: glaucomatous patients with cataract who underwent isolated cataract surgery and continued use of antiglaucomatous eye drops. We tested whether incorporating iStent® Trabecular Micro-Bypass in this scenario would be cost effective. The outcome measure was the incremental cost-effectiveness ratio (ICER: R$/PFLY). We performed univariate and probabilistic sensitivity analyses to test the robustness of the model. Results: Incorporating the iStent® Trabecular Micro-Bypass increases initial costs but improves disease control, making glaucoma stable longer and reducing future costs due to disease progression. The ICER was R$ 5,491.99/PFLY. The model was robust in sensitivity analyses. Conclusion: This analysis suggests that the incorporation of the iStent® Trabecular Micro-Bypass combined with cataract surgery would be cost-effective for joint cataract and POAG treatment in the supplementary health setting in Brazil.
- Subjects
BRAZIL; ECONOMIC aspects of diseases; OPEN-angle glaucoma; CATARACT surgery; EYE drops; BRAZILIANS
- Publication
JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde, 2020, Vol 12, Issue 2, p109
- ISSN
2175-2095
- Publication type
Article
- DOI
10.21115/JBES.v12.n2.p109-20