United States cost-effectiveness study of two dry eye ophthalmic lubricants.
OBJECTIVE
Dry eye is thought to be the most common ocular problem in the United States. However, it is only recently that it has been recognized as a disease with significant economic burden and impact on quality of life. This article presents an economic model of cost-effectiveness of two ophthalmic lubricants commonly used in the treatment of dry eye-Systane and Refresh Tears.


METHODS
We conducted a meta-analysis, pooling the results of two clinical trials of patients with dry eye treated with Systane and Refresh Tears which presented response rates for improvements in ocular dryness, the key symptom of dry eye. An economic model was used to estimate the incremental cost-effectiveness ratio (ICER) for Systane versus Refresh Tears over a 12 month treatment period.


RESULTS
Systane is significantly more effective than Refresh Tears at improving symptoms of "dryness" (75% vs 41%). Systane costs on average $57.79 per year more than Refresh Tears. Assigning a quality-adjusted life year (QALY) gain of 0.03 to responders results in an incremental cost per QALY gain of $5,837.


CONCLUSIONS
Both Refresh Tears and Systane are effective and cost-effective interventions. Systane costs more than Refresh Tears, however clinical trial evidence shows it to be more effective. The ICER for Systane versus Refresh Tears is well below the generally accepted $50,000 per QALY threshold.
Wlodarczyk
John
J
John Wlodarczyk Consulting Services, New Lambton, NSW, Australia. john@JWCS.com.au
Fairchild
Carol
C
D003362:Cost-Benefit Analysis; D015352:Dry Eye Syndromes / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D054327:Lubricants / Q000008:administration & dosage / Q000191:economics*; D018803:Models, Economic; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000191:economics*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome; D014481:United States
D054327:Lubricants; D009883:Ophthalmic Solutions