Study Reveals Potential Cost Efficiency of Using Glaukos iStent to Treat Elevated IOP

Glaukos Corporation, an ophthalmic medical technology company focused on the development and commercialization of glaucoma treatment products and procedures, said an analysis published in the Journal of Medical Economics evaluating various options for treating elevated intraocular pressure (IOP) in open-angle glaucoma patients showed that two iStent Trabecular Micro-Bypass Stents had a lower projected average cumulative cost at five years than either selective laser trabeculoplasty (SLT) or topical glaucoma medication only.
 
The population-based, annual state-transition, probabilistic, cost-of-care model used in the analysis was designed to assess direct costs for three treatment options—two iStents, SLT or topical medication only—over a five-year period. A clinician panel provided treatment strategy change probabilities and direct costs for drugs, procedures and complications that were included in the analysis.
 
According to the study authors, the projected average cumulative cost at five years was $4,420 for the two-stent procedure, compared to $4,730 for SLT and $6,217 for topical medication only. The model showed that while the two-stent procedure had the highest initial year cost, it also had the lowest annual marginal cost for each subsequent year. Over the same time period, costs in each year following SLT or topical medication only were more than double that of the two-stent procedure.
 
“While numerous international studies have shown the ability of two trabecular meshwork stents to effectively control IOP in open-angle glaucoma patients, this analysis is the first to reveal the potential cost efficiency of trabecular stenting, especially over longer time horizons,” said John P. Berdahl, M.D., a South Dakota-based ophthalmic surgeon and one of the authors of the Journal of Medical Economics article. “Our research indicates that the two-stent treatment option may reduce glaucoma-related health resource use and contribute to direct cost savings, particularly when compared to topical medication only, which is the most commonly used treatment option today but is often ineffective due to high rates of patient non-compliance.”
 
Glaukos is the study sponsor and the pioneer of Micro-Invasive Glaucoma Surgery, or MIGS. MIGS involves insertion of a micro-scale device from within the eye’s anterior chamber through a small corneal incision. MIGS devices are designed to reduce intraocular pressure by restoring the natural outflow pathways for aqueous humor. In 2012, Glaukos received U.S. Food and Drug Administration (FDA) approval for the iStent, which is implanted in conjunction with cataract surgery and has been shown to lower IOP in adult patients with mild-to moderate open-angle glaucoma.
 
The company also is pursuing FDA approval of two versions of its next-generation iStent inject Trabecular Micro-Bypass device: one for use in combination with cataract surgery and another for use in a standalone procedure. The iStent inject is designed to deploy two stents into separate trabecular meshwork locations and is being evaluated in FDA clinical trials for IOP reduction. The iStent inject is approved for use in the European Union, Canada, Australia, Singapore, and Brazil. The company also is pursuing FDA approval of a third MIGS device, the iStent SUPRA, which accesses the uveoscleral pathway for aqueous humor outflow.
 
“Our core strategy is to provide a full complement of micro-scale treatment options that can effectively manage IOP and overcome many of the drawbacks of conventional therapies,” said Thomas Burns, Glaukos president and CEO. “Peer-reviewed study results like these help to illustrate the potential for our technologies to offer important clinical and economic benefits for physicians, patients and the healthcare system.”
 
Glaucoma is characterized by progressive, irreversible and largely asymptomatic vision loss caused by optic nerve damage. There is no cure for the disease and reducing IOP is the only proven treatment. According to Market Scope, more than 80 million people worldwide have glaucoma, including 4.5 million people in the United States. Open-angle glaucoma is the most common form, affecting approximately 3.6 million people in the United States.
 
The iStent Trabecular Micro-Bypass Stent is indicated for use in conjunction with cataract surgery for the reduction of intraocular pressure (IOP) in adult patients with mild-to-moderate open-angle glaucoma currently treated with ocular hypotensive medication.
 
Glaukos is an ophthalmic medical technology company focused on the development and commercialization of glaucoma treatment products and procedures. The company pioneered Micro-Invasive Glaucoma Surgery, or MIGS, to revolutionize the traditional glaucoma treatment and management paradigm. Glaukos launched the iStent, its first MIGS device, in the United States in July 2012 and is leveraging its platform technology to build a comprehensive and proprietary portfolio of micro-scale injectable therapies designed to address the complete range of glaucoma disease states and progression. The company believes the iStent, measuring 1 mm long and 0.33 mm wide, is the smallest medical device ever approved by the FDA.