Budget impact analysis of the XEN® gel stent implant for glaucoma treatment

Abstract

ABSTRACTObjective: To determine the economic impact of the XEN® Gel Stent implant inclusion into the therapeutic arsenal for surgical treatment of open-angle glaucoma in Spain.Methods: A budget-impact analysis was designed to estimate the costs of surgical intervention in patients with not-controlled glaucoma from the perspective of the Spanish National Health System (NHS).A hypothetical cohort (135 patients with glaucoma) was analyzed and subdivided into three subgroups considering the appropriate interventions: cataracts, iStent®+cataracts, ExPRESS®±cataracts, trabeculectomy±cataracts, and non-penetrating deep sclerectomy (NPDS)±cataracts.The current scenario was compared along a 3-years, with a future scenario considering XEN® for mild glaucoma+cataracts cases (3%) and moderate glaucoma+cataracts and glaucoma without cataracts cases; 30% (year 1), 35% (year 2) and 40% (year 3).The estimation of total cost (€,2016) included the following components: device costs, surgical interventions, follow-up visits, complications management, and additional procedures costs.An expert panel provided proportions of use and resource consumption for each intervention. Unitary costs derived from a national database.Results: The current cost for surgical treatment of glaucoma resulted €4,665.41/patient. The inclusion of the XEN® implant would generate savings of €465.24 in year 1 and €618.82 (years 2–3).Conclusion: XEN® implant inclusion for surgical treatment of glaucoma would result in cost-savings for the NHS.