title: Cost-offset analysis: bimatoprost versus other prostaglandin analogues in open-angle glaucoma.
abstract: OBJECTIVE
  To develop a cost-offset model from a US payer perspective comparing glaucomatous progression and costs among primary open-angle glaucoma (POAG) patients using bimatoprost, latanoprost, or travoprost.
  
  
  METHODS
  Cost-offset model.
  
  
  METHODS
  A Markov cohort model was used to estimate glaucomatous progression for POAG patients over 7 years. The model assumed bimatoprost-treated patients had lower resulting intraocular pressure (IOP) (by 1 mm Hg) for all presenting IOP categories than latanoprost- or travoprost-treated patients. Patients with lower IOP were assumed to have lower probability of progression. Those that progressed were assumed to do so at a rate of -0.6 dB per year. Direct costs associated with mean deviation score categories were applied to each treatment cohort to calculate the expected 7-year costs of treating patients with each prostaglandin analogue (PGA). Literature was used to support assumptions. A budget impact analysis was conducted where all travoprost patients switched to generic latanoprost and where all bimatoprost patients switched to generic latanoprost. The base case market share was 22% bimatoprost, 23% travoprost, and 55% latanoprost.
  
  
  RESULTS
  Model results demonstrate that for a managed care plan with 9500 PGA-treated glaucoma patients, exclusive bimatoprost use would prevent progression in 136 additional individuals compared with exclusive travoprost or latanoprost treatment. Model results demonstrate that greater IOP reduction from bimatoprost is associated with increased cost savings compared with latanoprost or travoprost treatments.
  
  
  CONCLUSIONS
  Model results demonstrate that greater IOP reduction from bimatoprost could reduce managed care spending.
authors: Analytica International, New York, NY, USA.
authors: Karina L
authors: KL
authors: Berenson
authors: Steven
authors: S
authors: Kymes
authors: David A
authors: DA
authors: Hollander
authors: Richard
authors: R
authors: Fiscella
authors: Caroline
authors: C
authors: Burk
authors: Vaishali D
authors: VD
authors: Patel
mesh_terms: D000577:Amides / Q000191:economics* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use; D000069580:Bimatoprost; D003008:Cloprostenol / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000191:economics*; D017048:Health Care Costs; D006305:Health Status Indicators; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D000077338:Latanoprost; D008329:Managed Care Programs; D008390:Markov Chains; D018803:Models, Economic; D011461:Prostaglandins F, Synthetic / Q000191:economics* / Q000627:therapeutic use; D011465:Prostaglandins, Synthetic / Q000191:economics* / Q000627:therapeutic use; D013997:Time Factors; D000069557:Travoprost; D014481:United States
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D011461:Prostaglandins F, Synthetic; D011465:Prostaglandins, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069580:Bimatoprost; D000069557:Travoprost