A study compared the iStent Inject, Kahook Dual Blade (KDB), Trabectome, and Hydrus Microstent and found KDB to be most cost-effective in terms of cost per mmHG of IOP reduction.
Outcome and published data were analyzed, and costs were determined based on acquisition costs at NYU Langone Health for each device. Utilizing the CVS Caremark website, researchers calculated that the average annual cost of generic topical glaucoma medications per patient was $58.41.
All devices were found to have similar outcomes with significant differences in cost-effectiveness. Below is a breakdown of results per device.
iStent Inject
Device cost (per unit): $2275 (2 injects)
IOP reduction: 7.0
Number of medications reduced: 1.2
Cost per mmHG of IOP reduction: $325
Time (years) for Cost of Device (Cost savings from medication reduction): 32.5
KDB
Device cost (per unit): $495
IOP reduction: 4.6
Number of medications reduced: 0.7
Cost per mmHG of IOP reduction: $107
Time (years) for Cost of Device (Cost savings from medication reduction): 12.1
Trabectome
Device cost (per unit): $749 + $29,999 console
IOP reduction: 4.5
Number of medications reduced: 1.2
Cost per mmHG of IOP reduction: $265
Time (years) for Cost of Device (Cost savings from medication reduction): 12.1
Hydrus Microstent
Device cost (per unit): $1900
IOP reduction: 7.6
Number of medications reduced: 1.4
Cost per mmHG of IOP reduction: $250
Time (years) for Cost of Device (Cost savings from medication reduction): 23.2
The authors concluded that KDB device was the most cost-effective in terms of cost per mmHG of IOP reduction, but noted that the length of the trial was only 6 months. In addition, generic medication costs were also found to be “relatively inexpensive compared to MIGS device costs.”
Reference
Chen S, et al. A cost-effectiveness comparison of minimally-invasive glaucoma surgery (MIGS) devices. Presented at: AGS 2021.
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