Abstract

BackgroundMydriasert is an insoluble ophthalmic insert indicated for mydriasis prior to cataract surgery, which gradually releases the active ingredients: tropicamide (0.25 mg) and phenylephrine (5.38 mg). This study aimed to evaluate the cost of Mydriasert compared with conventional mydriatic eye drops to induce pupil dilation prior to cataract surgery using a budget impact model.MethodsA cohort-based, decision tree, budget impact model was developed to estimate the drug, consumable and staff costs for achieving mydriasis with Mydriasert compared to mydriatic eye drops (tropicamide [1 %] plus phenylephrine [10 %]). Insights from structured interviews with clinicians (n = 5) experienced in using both Mydriasert and mydriatic eye drops and results from the current clinical study of patients undergoing cataract surgery (n = 144) at a Greater London district general hospital were used to obtain key input parameters for the model, and to validate the model approach.ResultsThe base case analysis in a cohort of 1763 patients undergoing cataract surgery showed that when Mydriasert substituted mydriatic eye drops, annual total costs decreased by 18 % and annual total nurse time decreased from 235.1 hours to 44.1 hours over one year (2012–2013).ConclusionsThis study demonstrated that despite its higher unit cost than mydriatic eye drops, Mydriasert resulted in overall savings in health-care costs, mainly associated with reduced nursing time. The economic model developed could assist National Health Service managers and local payers to estimate the budget impact of the introduction of Mydriasert into different clinical settings.

Highlights

  • Mydriasert is an insoluble ophthalmic insert indicated for mydriasis prior to cataract surgery, which gradually releases the active ingredients: tropicamide (0.25 mg) and phenylephrine (5.38 mg)

  • This study aimed to evaluate the cost of Mydriasert compared to conventional mydriatic eye drops to induce pupil dilation prior to cataract surgery using a budget impact model

  • A budget impact model was developed to estimate the drug, consumable and staff costs for achieving mydriasis using Mydriasert compared with mydriatic eye drops

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Summary

Introduction

Mydriasert is an insoluble ophthalmic insert indicated for mydriasis prior to cataract surgery, which gradually releases the active ingredients: tropicamide (0.25 mg) and phenylephrine (5.38 mg). This study aimed to evaluate the cost of Mydriasert compared with conventional mydriatic eye drops to induce pupil dilation prior to cataract surgery using a budget impact model. Mydriasert® (Laboratoires Théa) is an insoluble ophthalmic insert indicated for pre-surgical mydriasis, which gradually releases the active ingredients: tropicamide (0.25 mg) and phenylephrine (5.38 mg) [3]. This study aimed to evaluate the cost of Mydriasert compared to conventional mydriatic eye drops (tropicamide [1 %] plus phenylephrine [10 %]) to induce pupil dilation prior to cataract surgery using a budget impact model. A prospective clinical evaluation of the introduction of Mydriasert for pre-operative pupillary dilation in a Greater London district general hospital ophthalmology department provided input parameters for the economic model. The economic model was designed to assist National Health Service (NHS) managers and local payers in considering the cost implications of introducing Mydriasert into different clinical settings

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