To view enhanced content for this article go to http://www.medengine.com/Redeem/DFCCF0603B3F87D1.
It is hypothesized that using fluocinolone acetonide (FAc) implants such as Iluvien for the treatment of diabetic macular edema (DME) may reduce the total number of intravitreal injections and clinic visits, resulting in an overall treatment cost reduction. The primary aim of this study is to identify the real-world cost savings achievable in a tertiary National Health Service (NHS) hospital.
A retrospective cost analysis study was conducted. The inclusion criteria were patients with refractory DME who were switched to Iluvien. The average yearly costs were calculated both before and after the switch to Iluvien. All costs including medicines, investigations, clinics, and management of raised intraocular pressure (IOP) were calculated. The cost differences over the 3 years’ worth of Iluvien treatment were calculated and analyzed. To ensure non-inferiority of this treatment intervention, the best corrected visual acuity (BCVA) and central retinal thickness (CRT) were also analyzed. Statistical analysis was conducted with a Student t test where appropriate and statistical significance is identified where p < 0.05.
Fourteen eyes of 13 patients met the inclusion criteria. Switching patients to Iluvien achieved on average a saving of £2606.17 per patient (p = 0.33) over the 3 years. However, seven cases (50%) had a rise in IOP after Iluvien that warranted medical treatment and two cases (14.3%) required glaucoma surgery. Incorporating the costs of glaucoma management reduced the overall savings over 3 years to £1064.66 per patient. The BCVA and CRT analysis showed a non-inferiority relationship between Iluvien and any previous treatment.
The use of Iluvien in refractory DME patients represents a cost- and time-saving procedure, while showing non-inferiority in terms of efficacy.
National Institute for Health and Clinical Excellence. Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular edema after an inadequate response to prior therapy. Technology appraisal guidance TA301. London: NICE; 2013.
Mourtzoukos S. The treatment of diabetic macular edema (DME) in UK real-life clinical practice with ILUVIEN ® (fluocinolone acetonide)—its impact on current clinical practice. Expert Rev Ophthalmol. 2017;12(2):95–7. CrossRef
National Health Service England. 2014/15 National Tariff Payment System Annex 5A—National Prices. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/300551/Annex_5A_National_Prices.xlsx. Accessed Mar 28, 2017.
Joint Formulary Committee. British National Formulary (BNF) 72. London: BMJ Publishing Group Ltd and Royal Pharmaceutical Society; 2016.
Ch’ng S, Brent A, Banerjee S. The economic impact of Intravitreal fluocinolone acetonide (Iluvien ®) in refractory diabetic macular edema in the National Health Service (NHS), United Kingdom. In: [Poster] EURETINA Copenhagen, 8–11th September 2016.
Quhill F. Cumulative cost of treatment with Iluvien (fluocinolone acetonide [FAC]) versus the current standard of care in the treatment of visual impairment due to diabetic macular edema (DME) in phakic eyes over a 3 year period: an analysis from a UK healthcare perspective. In: [Poster] ISPORT 19th Annual European Congress, Austria, 29th October 2016.
- Real-World Cost Savings Demonstrated by Switching Patients with Refractory Diabetic Macular Edema to Intravitreal Fluocinolone Acetonide (Iluvien): A Retrospective Cost Analysis Study
Soon W. Ch’ng
Alexander J. Brent
- Springer Healthcare
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II