PSS37 - A SYSTEMATIC REVIEW OF THE METHODOLOGICAL QUALITY OF ECONOMIC STUDIES EVALUATING OPHTHALMIC DRUGS

Abstract

To identify, characterize and assess the methodological quality of studies conducted to evaluate the economic value of ophthalmic drugs. A systematic search was conducted in Pubmed and Embase from its inception up to February 2018. Full economic evaluation studies met the inclusion criteria whether they evaluate ophthalmic drugs compared to other drugs or no treatment. Therapeutic areas, interventions, type of analysis and effectiveness measures were extracted from the included studies. The methodological quality was evaluated according to the British Medical Journal (BMJ) checklist. Quality indicators were evaluated by the Fisher’s exact test. Ninety-one studies were included, 47 (51.6%) conducted a cost-utility analysis, 28 (30.8%) a cost-effectiveness analysis and 16 (17.6%) a cost-effectiveness and cost-utility analysis simultaneously. Biologic agents (n=51; 35.7%) as ranibizumab, pegaptanib and aflibercept, and verteporfin (n=14; 9.8%) were the most evaluated drugs. The majority of studies evaluated drugs for age-related macular degeneration [AMD] (n=41; 45.1%), glaucoma and ocular hypertension (n=19; 20.9%) and conjunctivitis allergic (n=6; 6.6%). Quality-adjusted-life-years was estimated in 62 studies (68.1%), followed by the reduction in intraocular pressure (n=9; 9.9%). Based on BMJ checklist, all studies presented, at least, three methodological limitations. Studies conducted from a health system perspective, with time horizons longer than one year and that rely on observational data or observational and experimental data simultaneously are associated with higher methodological quality. Studies which described the type of model, presented statistical analyses and report the sensitivity analysis approach had higher methodological quality scores as well. The results of this study identified indicators of the quality of pharmacoeconomic evaluations of ophthalmic drugs. Improving the quality and comparability of pharmacoeconomic studies enhance their rigor and usefulness in the decision-making processes.