A study published Online First by Archives of Ophthalmology, reveals that glaucoma medication known as prostaglandin analogs (PGAs) and laser trabeculoplasty (LTP), a small invasive procedure both seem cost-effective options for patients with newly diagnosed mild open-angle glaucoma. However, in light of the current prices for PGAs, LTP could prove more cost effective in cases where medication adherence is not optimal.

The researchers conclude that assuming optimal medication adherence, generic PAGs confer greater value than with LTP.

In the United States, open-angle glaucoma (OAG), an eye condition that leads to damage to the the optic nerve, is one of the primary causes of irreversible blindness, affecting over 3 million individuals.

Results from previous human trials have demonstrated that the risk of developing OAG among individuals with ocular hypertension can be lowered by reducing intraocular pressure (IOP). Furthermore, decreasing IOP can lower the risk for disease progression in individuals suffering with glaucoma. IOP can be reduced using topical glaucoma medications, incisional glaucoma surgery and LTP.

A cost-effectiveness examination was conducted using a mathematical method, by Joshua D. Stein, M.D., M.S., of the University of Michigan, Ann Arbor, and his team, of treating individuals diagnosed with mild open-angle glaucoma with LTP, PGAs or observation only.

The researchers explain:

“The incremental cost-effectiveness of LTP over no treatment was $16,824 per QALY [quality-adjusted life year]. However, the incremental cost-effectiveness of PGAs over no treatment was $14,179 per QALY, and PGAs provide greater health-related quality of life relative to LTP.”

According to the researchers, if PGAs are 25% less effective as a result of poor patient medication adherence, LTP could be the favorable option.

They conclude:

“Our findings highlight the importance of medication adherence in determining which intervention is most cost-effective.”

Written by: Grace Rattue