Clinical Ophthalmology (Feb 2022)
Cost–Utility Analysis of a Latanoprost Cationic Emulsion (STN1013001) versus Other Latanoprost in the Treatment of Open-Angle Glaucoma or Ocular Hypertension and Concomitant Ocular Surface Disease in Germany
Abstract
Carlo Lazzaro,1 Cécile van Steen,2 Stephan Billeit,3 Heinrich Frauenknecht,4 Christopher Kallen,5 Stefan Pfennigsdorf,6 Ulrich Thelen,7,8 Luigi Angelillo2 1Health Economist and Research Director, Studio di Economia Sanitaria, Milan, Italy; 2Santen GmbH, München, Germany; 3Private Practicing Ophthalmologist, Lübeck, Germany; 4Private Practicing Ophthalmologist, Treuchtlingen, Germany; 5Private Practicing Ophthalmologist, Krefeld, Germany; 6Private Practicing Ophthalmologist, Polch, Germany; 7Private Practicing Ophthalmologist, Münster, Germany; 8University Hospital Muenster, Department of Ophthalmology, Münster, GermanyCorrespondence: Carlo LazzaroHealth Economist and Research Director, Studio di Economia Sanitaria, Via Stefanardo da Vimercate, 19, Milan, I-20128, Italy, Tel/Fax +39 02 2600 0516, Email [email protected]: This study aimed to estimate the cost–utility and economic value of STN1013001, a latanoprost cationic emulsion vs other latanoprost formulations (henceforth latanoprost) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) and concomitant ocular surface disease (OSD) in Germany.Methods: An early 5-year Markov model-supported cost–utility analysis was performed to estimate costs, quality-adjusted life years (QALYs) and life-years saved (LYS) for STN1013001 vs latanoprost from the German health system perspective. The model included seven mutually exclusive health states and adopted a 1-year cycle length. The model was populated with pooled data derived, by means of a questionnaire, from a convenience sample of five German glaucoma specialists. Remaining data were derived from published sources. Data provided by the ophthalmologists included annual treatment adherence probabilities, utility values and resource utilization. The half-cycle correction as well as a discount rate of 3.0% per year were applied to costs (expressed in € 2020), life-year saved (LYS) and QALYs. The incremental cost–utility ratio (ICUR) was contrasted against the informal willingness-to-pay (WTP) threshold for incremental LYS saved or QALY gained (€ 30,000) proposed for Germany. One-way and probabilistic sensitivity analyses (OWSA; PSA) tested the robustness of the base case ICUR.Results: Over the 5-year time horizon, STN1013001 strongly dominates latanoprost as it is less costly (€ 1003.65 vs € 1145.37; − 12.37%) and produces more QALYs (2.612 vs 2.365; +10.44%) per notional patient. Baseline findings were robust against all the variations included in OWSA. PSA shows that STN1013001 has a 100% probability of being cost-effective vs Latanoprost at each WTP threshold for incremental QALY gained.Conclusion: Once on the market, STN1013001 will provide a cost-effective and possibly strongly dominant therapy vs latanoprost for OAG/OHT+OSD patients from a German health system perspective. Future empirical research should confirm these findings.Keywords: open-angle glaucoma, ocular surface disease, STN1013001, latanoprost, cost–utility analysis, Germany
