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Latanoprostene Bunod Proves Cost-Effective for Primary Open-Angle Glaucoma

When compared to prostaglandin analogs (PGA), latanoprostene bunod appears to be cost-saving in the treatment of primary open-angle glaucoma, according to data presented at AMCP Nexus 2019. 

According to the study, “Latanoprostene bunod is a nitric oxide donating PGA that lowers intraocular pressure (IOP) significantly more than branded latanoprost and has a low rate of discontinuation,” but there have not been studies before this one to measure its cost-effectiveness.

Jordana K Schmier, MA, senior managing scientist, Exponent, and Alan L Robin, MD, associate professor ophthalmology and international health, Johns Hopkins University, conducted the study to measure the potential cost-effectiveness of latanoprostene bunod with branded PGAs and found over 2 years, latanoprostene bunod 0.024% was cost-saving compared to PGAs, with lower costs and higher utilities. 

The study—the first study focused on such a comparison—used a decision-analytic model to estimate clinical and health utility outcomes for latanoprostene bunod and an aggregate branded PGA alternative, developed using market-based distributions and weighted effectiveness, safety and cost estimates, over 2 years in 3-month cycles.

The researchers reported that clinical output data was sourced from prescribing information and published papers. Resource use was estimated from a combination of treatment pattern guideline data and published studies. 

According to the study abstract, health utilities were assigned to health states based on published estimates; a US Medicare payer perspective was used, and outcomes were discounted at 3% annually. Also, sensitivity analyses examined the influence of key parameters.

In the base case, 2-year costs for latanoprostene bunod were $6168 compared to $6619 for the PGA. 

Latanoprostene bunod measured 1.60  quality adjusted life years (QALYs) compared to PGAs’ 1.58. 

In costs, patients paid $4176 and $4150 for latanoprostene bunod and PGAs, the treatment and adjunctive therapy, respectively. 

Sensitivity analyses found that the benefit was sometimes reduced but never eliminated when various assumptions were modified, according to researchers. 

“Real-world data should be gathered to update assumptions made in this model; however, these initial estimates suggest that incremental improvements in IOP control and reductions in hyperemia rates can have a meaningful impact on two-year glaucoma costs and health outcomes,” concluded researchers.

This study was sponsored by Bausch Health. —Edan Stanley

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