title: Review of economic studies and budget impact analysis of ocriplasmin as a treatment of vitreomacular traction.
abstract: OBJECTIVE
  To review the evidence on the cost-effectiveness of ocriplasmin as a treatment for vitreomacular traction (VMT), and to estimate the impact on the Spanish National Health System (NHS).
  
  
  METHODS
  1) Systematic review. The following databases were searched in January 2015: MEDLINE, PREMEDLINE, EMBASE, CRD, the Cochrane Library, and key websites. Selection criteria were: full economic evaluations that compared ocriplasmin with usual care ('watch and wait' and/or vitrectomy) in patients with VMT. The outcomes to extract were costs of the alternatives and the incremental cost-effectiveness ratio. Studies of budget impact analysis were also included. The methodological quality was assessed, and a narrative synthesis of the included studies was carried out. 2) Estimation of budget impact. The impact on the budget as a result of the introduction of ocriplasmin in the NHS was estimated, including data from different sources.
  
  
  RESULTS
  Six studies were identified, none of them performed in Spain. The two best studies concluded that ocriplasmin is cost-effective in their respective countries (Canada and United Kingdom), but only in patients with certain conditions (without epiretinal membrane, for example). The results of the budget impact analysis are different between countries. The analysis for Spain showed that the introduction of ocriplasmin would mean a saving over 1 million Euros for the NHS in 5 years.
  
  
  CONCLUSIONS
  The cost-effectiveness of ocriplasmin has not been demonstrated in Spain. However, good studies performed in other countries found that ocriplasmin is cost-effective in selected patients. Given the current prices in Spain, ocriplasmin could involve a saving for the Spanish NHS.
authors.affiliation: Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Tenerife, España; Fundación Canaria de Investigación Sanitaria (FUNCANIS), Tenerife, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, La Laguna, España. Electronic address: lidia.garciaperez@sescs.es.
authors.forename: L
authors.initials: L
authors.lastname: García-Pérez
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Nuestra Señora de La Candelaria, Tenerife, España.
authors.forename: R
authors.initials: R
authors.lastname: Abreu-González
authors.affiliation: Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Tenerife, España; Fundación Canaria de Investigación Sanitaria (FUNCANIS), Tenerife, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, La Laguna, España.
authors.forename: J
authors.initials: J
authors.lastname: Pérez-Ramos
authors.affiliation: Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: García-Pérez
authors.affiliation: Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Tenerife, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, España; Centro de Investigaciones Biomédicas de Canarias (CIBICAN), Universidad de La Laguna, La Laguna, España. Electronic address: pseragu@gobiernodecanarias.org.
authors.forename: P
authors.initials: P
authors.lastname: Serrano-Aguilar
mesh_terms: D002017:Budgets; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005341:Fibrinolysin / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D058449:Intravitreal Injections; D015337:Multicenter Studies as Topic; D010446:Peptide Fragments / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012164:Retinal Diseases / Q000188:drug therapy* / Q000191:economics / Q000209:etiology / Q000601:surgery; D012167:Retinal Perforations / Q000188:drug therapy / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D013030:Spain; D013222:State Medicine / Q000191:economics*; D013314:Stress, Mechanical; D016896:Treatment Outcome; D014821:Vitrectomy / Q000191:economics; D020255:Vitreous Detachment / Q000150:complications
chemical_list: D010446:Peptide Fragments; C054561:microplasmin; D005341:Fibrinolysin
keywords: Cost-effectiveness; Coste-efectividad; Economic impact; Impacto presupuestario; Ocriplasmin; Ocriplasmina; Revisión sistemática; Systematic review; Tracción vitreomacular; Vitreomacular traction