Cost-Effectiveness Analysis of Minimally Invasive Trabecular Meshwork Stents with Phacoemulsification

Sood, Shefali; Heilenbach, Noah; Sanchez, Victor; Glied, Sherry; Chen, Sien; Al-Aswad, Lama A.

doi:10.1016/j.ogla.2021.09.006

Cited by 23 publications

(32 citation statements)

References 53 publications

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“…For these reasons, HMS implantation combined with CS has been shown to be cost-effective and to maintain a favorable quality-adjusted life year compared with CS alone. 12 The 2-year findings from the HORIZON study showed that HMS implantation combined with CS provided a statistically and clinically significant reduction in unmedicated diurnal IOP compared with cataract CS alone. Although the 5-year results do not include medication washout, the IOP and medication use are consistent with the 1-and 2-year findings.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes from the HORIZON Randomized Trial for a Schlemm’s Canal Microstent in Combination Cataract and Glaucoma Surgery

Ahmed¹,

Francesco²,

Rhee³

et al. 2022

Ophthalmology

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Section: Discussionmentioning

confidence: 99%

Long-term Outcomes from the HORIZON Randomized Trial for a Schlemm’s Canal Microstent in Combination Cataract and Glaucoma Surgery

Ahmed¹,

Francesco²,

Rhee³

et al. 2022

Ophthalmology

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“… 43 Separate studies have shown either the Hydrus 44 or the iStent inject 45 46 combined with phacoemulsification is cost-effective for patients with mild to moderate OAG versus phacoemulsification alone. A recent study by Sood et al 47 compared the cost-effectiveness of the Hydrus and the iStent inject in combination with phacoemulsification for patients with mild to moderate primary OAG. Both devices were not cost-effective versus phacoemulsification alone over the first 2 years due to the initial costs of the surgeries, however, these devices were demonstrated to be cost-effective treatment options over a lifetime horizon based on the simulation analysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hydrus and iStent microinvasive glaucoma surgery implants in combination with phacoemulsification for treatment of open-angle glaucoma: systematic review and network meta-analysis

Guo

Hong

et al. 2022

BMJ Open

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ObjectivesTo compare the efficacy and safety of two Schlemm’s canal-based microinvasive glaucoma surgery (MIGS) devices, the Hydrus Microstent and the iStent Trabecular Bypass combined with phacoemulsification for treatment of open-angle glaucoma.DesignSystematic review and network meta-analysis.MethodsLiterature searches were conducted on PubMed, Web of Science, Cochrane Library and ClinicalTrials.gov to identify randomised controlled trials (RCTs) assessing the Hydrus or the iStent implantation combined with phacoemulsification for treatment of open-angle glaucoma until September 2020. Risk of bias was assessed using a six-item modified Jadad scale. Effects were estimated using the intraocular pressure (IOP) reduction (IOPR), the percentage of IOPR and the proportion of medication-free patients at follow-up end. Safety was estimated using the proportions of adverse events. The network meta-analysis was conducted within a Bayesian framework using the Markov Chain Monte Carlo method in ADDIS software.ResultsSix prospective RCTs comprising 1397 patients were identified. Regarding the absolute value and the percentage of IOPR, the Hydrus and 2-iStent implantation combined with phacoemulsification were significantly more effective than phacoemulsification alone. Rank probability analysis revealed the Hydrus might be the best choice to lower IOP. There was no significant difference in the proportion of medication-free patients among groups. The Hydrus and 2-iStent implantation had a higher probability to achieve the medication-free status versus the 1-iStent implantation and phacoemulsification alone. Overall safety profiles were good for each device with the focal peripheral anterior synechiae more frequently reported in Hydrus eyes.ConclusionsThe Hydrus implantation may have a slight advantage over the 1-iStent or 2-iStent implantation in combination with phacoemulsification to treat open-angle glaucoma. Our findings might be of some uncertainty due to the limited included data. Further studies are needed to investigate whether our findings are robust, including high-quality RCTs to directly compare these MIGS devices.

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“…From 2000 to 2009, there were 7 publications (38.9%), 7,[14][15][16][17][18][19] whereas from 2010 to 2021, there were 10 publications (55.6%). [20][21][22][23][24][25][26][27][28][29] The research publications of the 1980s focused on screening, whereas most of the research from 2000 to 2009 focused on treatments for glaucoma. This increase correlates with the introduction of latanoprost in the United States in 1996, a breakthrough discovery in the treatment of glaucoma.…”

Section: Timeline Of Publicationmentioning

confidence: 99%

A Review of Cost-Effectiveness Analyses for Open Angle Glaucoma Management

Sood

Iskander

Heilenbach

et al. 2023

Journal of Glaucoma

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Purpose: Cost-effectiveness analyses (CEAs) quantify and compare both costs and measures of efficacy for different interventions. As the costs of glaucoma management to patients, payers, and physicians are increasing, we seek to investigate the role of CEAs in the field of glaucoma and how such studies impact clinical management. Methods: We adhered to the “Preferred Reporting Items for Systematic Reviews and Meta-analyses” guidelines for our systematic review structure. Eligible studies included any full-text articles that investigated cost-effectiveness or cost-utility as it relates to the field of open angle glaucoma management in the United States. Risk of bias assessment was conducted using the validated Joanna Briggs Institute Critical Appraisal Checklist for Economic Evaluations. Results: Eighteen studies were included in the review. Dates of publication ranged from 1983 to 2021. Most of the studies were published in the 2000s and performed CEAs in the domains of treatment/therapy, screening, and adherence for patients with primary angle open glaucoma. Of the 18 articles included, 14 focused on treatment, 2 on screening, and 2 on adherence. Most of these studies focused on the cost-effectiveness of different topical medical therapies, whereas only a few studies explored laser procedures, surgical interventions, or minimally invasive procedures. Economic models using decision analysis incorporating state-transition Markov cycles or Montecarlo simulations were widely used, however, the methodology among studies was variable, with a wide spectrum of inputs, measures of outcomes, and time horizons used. Conclusion: Overall, we found that cost-effectiveness research in glaucoma in the United States remains relatively unstructured, resulting in unclear and conflicting implications for clinical management.

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Cost-Effectiveness Analysis of Minimally Invasive Trabecular Meshwork Stents with Phacoemulsification

Cited by 23 publications

References 53 publications

Long-term Outcomes from the HORIZON Randomized Trial for a Schlemm’s Canal Microstent in Combination Cataract and Glaucoma Surgery

Long-term Outcomes from the HORIZON Randomized Trial for a Schlemm’s Canal Microstent in Combination Cataract and Glaucoma Surgery

Comparison of Hydrus and iStent microinvasive glaucoma surgery implants in combination with phacoemulsification for treatment of open-angle glaucoma: systematic review and network meta-analysis

A Review of Cost-Effectiveness Analyses for Open Angle Glaucoma Management

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