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. 2022 Feb 9:16:323-337.
doi: 10.2147/OPTH.S351013. eCollection 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

Carlo Lazzaro  1 , Cécile van Steen  2 , Stephan Billeit  3 , Heinrich Frauenknecht  4 , Christopher Kallen  5 , Stefan Pfennigsdorf  6 , Ulrich Thelen  7   8 , Luigi Angelillo  2
Affiliations

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

Carlo Lazzaro et al. Clin Ophthalmol. .

Abstract

Purpose: 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: Germany; STN1013001; cost–utility analysis; latanoprost; ocular surface disease; open-angle glaucoma.

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Conflict of interest statement

CL has received an unconditional research grant from Santen GmbH, München, Germany. Outside this research, in the past 3 years CL has received research grants, speaker or consultancy fees from AstraZeneca S.p.A., Boehringer Ingelheim Italia S.p.A., CSL Behring S. p.A., Ferring S.p.A., Ipsen S.p.A., Roche S.p.A., Sanofi s.r.l., Santen GmbH, Shire S.p.A, Sobi S.p.A. CvS and LA are employees of Santen GmbH, München, Germany. SB, HF, CK, SP and UT received research fee for data provision from Santen GmbH, München, Germany. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Markov model.
Figure 2
Figure 2
(A) Markov trace for the hypothetical cohort of patients on STN1013001. (B) Markov trace for the hypothetical cohort of patients on latanoprost.
Figure 3
Figure 3
One-way sensitivity analysis: results concerning the first 10 parameters of the Markov model that causes the widest variations in base case ICUR (€2020).a,b
Figure 4
Figure 4
Probabilistic sensitivity analysis. Cost-effectiveness plane (10,000 out of 10,000 Monte Carlo iterations reported) (ΔC in €2020).a,b
Figure 5
Figure 5
Probabilistic sensitivity analysis. Cost-effectiveness acceptability curve (1000 out of 1000 threshold values reported) (€2020).a
Figure 6
Figure 6
Probabilistic sensitivity analysis. Cost-effectiveness acceptability frontier (1000 out of 1000 threshold values reported) (€2020).a,b
See this image and copyright information in PMC

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