Hydrus® Microstent In Combination With Cataract Surgery In Patients With Mild To Moderate Poag: Cost-Effectiveness Analysis In Uk Settings

In a 5-year trial (HORIZON) Hydrus® Microstent demonstrated superior benefits when used in combination with cataract surgery (CS) to treat patient with mild to moderate glaucoma. This analysis evaluates the cost-effectiveness of Hydrus® Microstent + CS vs CS alone from the UK public payer perspective over a 15-year time horizon.

This economic evaluation is based on UK healthcare system data, utilizing publicly available cost sources and literature.

A semi-Markov model simulated the natural history of POAG to assess patient costs, health outcomes, and quality-adjusted life years (QALYs) over 15 years. The population was 71 years of age, with 80% having bilateral disease. The annualized rate of progression (RoP) was derived from post-hoc analysis of 5-year visual fields loss (VFL) data from HORIZON.  Medication use was modeled as a proxy for disease progression. Deterministic, probabilistic, and scenario analyses were conducted to assess the robustness of results.

Hydrus® + CS was associated with 4.4% lower total costs compared to CS alone (£20,031 vs £20,953) while providing greater QALYs (7.590 vs 7.256) over a 15-year horizon, demonstrating cost-effectiveness. Probabilistic analysis showed that Hydrus® + CS had a ~90% probability of being cost-effective at a willingness-to-pay threshold of £20,000/QALY.

Hydrus® implantation in combination with CS is a cost-effective intervention for long-term management of mild-to-moderate POAG, primarily due to reduced necessity for postoperative surgical interventions relative to CS alone.