Abstract
Glaucoma is a major cause of visual impairment and a chronic disease requiring treatment for lifetime. Management of intraocular pressure (IOP) is the main focus of treatment, and many pharmacological treatment agents are recommended and available in Korea. This study was conducted to facilitate efficient allocation of limited resources amongst various pharmacological agents. The objective of this study was to evaluate costs and effectiveness of two most commonly used drugs in Korea which are latanoprost and dorzolamide/timolol fixed combination. A decision analytic model was developed from a payer perspective to evaluate clinical effectiveness, costs and utility values of latanoprost and dorzolamide/timolol fixed combination. The model was constructed based on a one-month cycle with a time horizon of one year. The treatment success to measure effectiveness was defined as achieving a ≥20% reduction IOP from baseline. Costs of medication, diagnostic fees, physician and pharmacy visitation fees, and surgery fees were included in the study. Utility values according to the severity of glaucoma were also incorporated in the model. Treatment success and failure rates as well as utility for each health state were obtained from previously published literature and local market analysis data. Cost information was obtained from Korea-specific data sources. The result of this study was expressed in an incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis was conducted to evaluate different clinical parameters. The final effectiveness values for latanoprost and dorzolamide/timolol fixed combination were 0.9098 and 0.9089 in quality-adjusted life year (QALY), and the final costs were 550,737 KRW and 534,789 KRW respectively. Latanoprost displayed an ICER of 17,500,246 KRW/QALY compared to dorzolamide/timolol fixed combination. Under the currently implied ICER threshold in Korea, latanoprost can be interpreted as a cost-effective treatment option compared to dorzolamide/timolol fixed combination on the treatment of glaucoma.
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