title: The cost-effectiveness of the Argus II retinal prosthesis in Retinitis Pigmentosa patients.
abstract: BACKGROUND
  Retinitis Pigmentosa (RP) is a hereditary genetic disease causing bilateral retinal degeneration. RP is a leading cause of blindness resulting in incurable visual impairment and drastic reduction in the Quality of life of the patients. Second Sight Medical Products Inc. developed Argus II, a retinal prosthesis system for treating RP. Argus II is the world's first ever-commercial implant intended to restore some vision in the blind patients. The objective of this study was to assess the cost-effectiveness of the Argus® II Retinal Prosthesis System (Argus II) in Retinitis Pigmentosa (RP) patients.
  
  
  METHODS
  A multi -state transition Markov model was developed to determine the cost-effectiveness of Argus II versus usual care in RP from the perspective of healthcare payer. A hypothetical cohort of 1000 RP patients aged 46 years followed up over a (lifetime) 25-year time horizon. Health outcomes were expressed as quality adjusted life years (QALYs) and direct healthcare costs expressed in 2012 €. Results are reported as incremental cost per ratios (ICERs) with outcomes and costs discounted at an annual rate of 3.5%.
  
  
  RESULTS
  The ICER for Argus II was €14,603/QALY. Taking into account the uncertainty in model inputs the ICER was €14,482/QALY in the probabilistic analysis. In the scenarios of an assumption of no reduction on cost across model visual acuity states or a model time horizon as short as 10 years the ICER increased to €31,890/QALY and €49,769/QALY respectively.
  
  
  CONCLUSIONS
  This economic evaluation shows that Argus II is a cost-effective intervention compared to usual care of the RP patients. The lifetime analysis ICER for Argus II falls below the published societal willingness to pay of EuroZone countries.
authors.affiliation: O-Zone Health Economics and Outcomes Research consultancy, Maastricht, The Netherlands. a.vaidya@maastrichtuniversity.nl.
authors.forename: Anil
authors.initials: A
authors.lastname: Vaidya
authors.forename: Elio
authors.initials: E
authors.lastname: Borgonovi
authors.forename: Rod S
authors.initials: RS
authors.lastname: Taylor
authors.forename: José-Alain
authors.initials: JA
authors.lastname: Sahel
authors.forename: Stanislao
authors.initials: S
authors.lastname: Rizzo
authors.forename: Paulo Eduardo
authors.initials: PE
authors.lastname: Stanga
authors.forename: Amit
authors.initials: A
authors.lastname: Kukreja
authors.forename: Peter
authors.initials: P
authors.lastname: Walter
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D015233:Models, Statistical; D019736:Prostheses and Implants / Q000191:economics*; D019057:Quality-Adjusted Life Years; D012174:Retinitis Pigmentosa / Q000191:economics / Q000601:surgery*
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