Abysheva L.D.¹, Avdeev R.V.², Alexandrov A.S.³, Basinsky A.S.⁴, Blyum E.A.⁵, Brezhnev A.Yu.⁶, Volkov E.N.⁷, Gazizova I.R.⁸, Galimova A.B.⁹, Gaponko O.V.¹⁰, Garkavenko V.V.¹¹, Getmanova A.M.¹², Gorodnichy V.V.³, Gorshkova M.S.¹³, Gusarevitch A.A.¹⁴, Diordiychuk S.V.^3, 15, Dorofeev D.A.¹⁶, Zhavoronkov S.A.¹³, Zavadsky P.Ch.¹⁷, Zakhidov A.B.¹⁸, Zvereva O.G.¹⁹, Karimov U.R.²⁰, Kulik A.V.²¹, Kuroyedov A.V.^3, 15, Lanin S.N.²², Lovpache Dzh.N.²³, Loskutov I.A.²⁴, Molchanova E.V.²⁵, Nefedov N.A.³, Ogorodnikova V.Yu.^3, 15, Onufrichuk O.N.²⁶, Petrov S.Yu.²⁷, Rozhko Yu.I.²⁸, Sidenko T.A.²⁹, Tashtitova L.B.¹, Khudzhatova M.S.¹

¹Scientific State Ophthalmology Institute, Almaty, Kazakhstan;
²Burdenko State Medical Academy, Voronezh, Russia;
³Mandryka Medicine and Clinical Center, Moscow, Russia;
⁴Prof. Basynsky Ophthalmology Center, Ltd., Orel, Russia;
⁵Ophthalmology Hospital, Shymkent, Kazakhstan;
⁶State Medical University, Kursk, Russia;
⁷Bayandin Ophthalmology Hospital, Murmansk, Russia;
⁸State Medical University, Ufa, Russia;
⁹Russian Eye and Plastic Surgery Center, Ufa, Russia;
¹⁰Region Clinical Hospital № 2, Vladivostok, Russia;
¹¹Voyno-Yasenetsky State Medical University, Krasnoyarsk, Russia;
¹²Regional Eye Hospital, Bryansk, Russia;
¹³Filatov City Clinical Hospital № 15, Moscow, Russia;
¹⁴Regional Hospital № 1, Novosibirsk, Russia;
¹⁵Pirogov Russian National Research Medical University, Moscow, Russia;
¹⁶Ophthalmology Hospital № 3, Chelyabinsk, Russia;
¹⁷State Medical University, Grodno, Belarus;
¹⁸Eye-Microsurgery Clinic «SAIFOPTIMA», Tashkent, Uzbekistan;
¹⁹Region Clinical Ophthalmology Hospital, Kazan, Russia;
²⁰Region Ophthalmology Hospital, Gulistan, Uzbekistan;
²¹«Meditsina» Medical Center, Moscow, Russia;
²²Makarov Ophthalmology Clinical Hospital, Krasnoyarsk, Russia;
²³Helmgoltz State Ophthalmology Institute, Moscow, Russia;
²⁴Semashko State Ophthalmology Hospital, Moscow, Russia;
²⁵State Medical Academy, Omsk, Russia;
²⁶Ophthalmic Diagnostic Center № 7, Saint-Petersburg, Russia;
²⁷Scientific State Ophthalmology Institute, Moscow, Russia;
²⁸State Hospital, Gomel, Belarus;
²⁹City Government Hospital № 5, Perm, Russia

 SUMMARY

Background. Glaucoma treatment cost-effectiveness studies are associated with the primary established risk factor for the disease progression – intraocular pressure level (IOP).

Objective. To study glaucoma treatment cost-effectiveness in patients with moderate and advanced glaucoma changes.

Material and methods. In prospective multicenter clinical-research study which was conducted by 36 investigators in 29 clinical centers from December 2013 to April 2014 the results of treatment of 115 patients (187 eyes) with advanced glaucoma changes were counted. Patients’ mean age was 66.33 ± 0.81 years (M ± σ); 68.00 (61.00; 72.00) (Ме, Q_25%; Q_75%). IOP-lowering treatment cost and cost-effectiveness were calculated with an adjustment for IOP-level compensation according to the Russian Glaucoma Society guidelines.

Results. Mean cost-effectiveness cost was 13.94 ± 0.66 roubles/day which was comparable to the theoretical cost of treatment but was 32% higher than the price that was actually paid for treatment. For prostaglandin analogues monotherapy and fixed combination of beta-blocker and prostaglandin analogue (BB+PG) the difference between the actual price and cost-effectiveness cost was 44% (8.94 ± 0.45 roubles vs. 12.91 ± 0.99 roubles and 9.69 ± 0.80 roubles vs. 13.92 ± 1.24 roubles respectively). At the same time for betablocker and carbonic anhydrase inhibitor fixed combination (BB+CAI) treatment this difference made up 64% (10.40 ± 1.32 roubles vs. 17.08 ± 2.91 roubles).

Conclusion. It is less expensive to achieve a controlled IOP-level with BB+PG fixed combination treatment compared to BB+CAI fixed combination treatment.

Keywords: glaucoma, intra-ocular pressure, cost-of-illness, cost-effectiveness.

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21.04.2015