ABSTRACT
AIM: To evaluate the cost-effectiveness of latanoprost, travoprost and bimatoprost monotherapy in open angle glaucoma in Norway, Sweden and Denmark(Scandinavia). METHODS: A Markov decision-analytic health economic model was developed to estimate the comparative cost-effectiveness of prostaglandin analogs. Health states were stable and progressed glaucoma. Transition probabilities for both primary open angle and exfoliation glaucoma were populated with data from published medical literature. Clinical practice patterns were derived from surveys obtained from 45 ophthalmologists dispersed throughout each country. Specific unit costs for each country were used for medications, clinic visits, diagnostics and therapies. Quality-of-life weights were assigned for visual acuity from 0. 50- 0. 84. The time horizon was five years. All analyses were from a payer perspective and cost results were discounted at 3% per annum.RESULTS: Latanoprost was less expensive and more effective than bimatoprost and travoprost in both Norway and Sweden. Latanoprost was up to 4% less expensive in Sweden and Norway and the costs of all three medicines were within 1.5% of each other in Denmark. In Denmark bimatoprost dominated travoprost and was slightly less expensive than latanoprost while latanoprost was more effective than bimatoprost or travoprost. Effectiveness was within a narrow range for all products in each country.CONCLUSION: Latanoprost provides a cost-effective alternative to other available prostaglandin analogs in Scandinavia.