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J.A. Stewart, M. Mychaskiw, W.C. Stewart; Cost–Utility of Timolol, Travoprost, Bimatoprost and Latanoprost in the Treatment of Glaucoma in Norway by Use of a Markov Model . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4412.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the cost–utility of timolol maleate, latanoprost, travoprost and bimatoprost in Norway.
A Markov model was constructed to assess the cost utility analysis. Health states were stable and progressive glaucoma. Transition probabilities for both primary open–angle and exfoliation glaucoma were derived from the medical literature. Norwegian unit costs for medications, patient visits and diagnostic as well as therapeutic procedures were used in creating the model. Practice patterns were derived from surveys completed by 12 practicing Norwegian ophthalmologists. The time horizon was five years. A payer perspective was adopted.
The costs–utility ratios (qualities–adjusted–life–year [QALY]) were: $1,049 for bimatoprost, $1,055 for travoprost, $1,029 for timolol maleate and $1,033 for latanoprost. Timolol dominated over all products whereas latanoprost dominated the other prostaglandin analogs, bimatoprost and travoprost. However, the results were similar between all products. The reason for the differences between medications that did exist is not completely explained by the data. The advantage with timolol maleate appeared to be derived from lower costs due to the availability of generics. The advantage of latanoprost over other prostaglandins may have resulted from a lower reported side effect profile and greater persistency, while providing a similar ocular hypotensive efficacy to the other prostaglandins.
Latanoprost provides a cost utility alternative to traditional timolol maleate monotherapy in Norway and is comparable to other available prostaglandins. A larger prospective trial should be performed to confirm these findings.
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