J Korean Ophthalmol Soc > Volume 51(6); 2010 > Article
Journal of the Korean Ophthalmological Society 2010;51(6):865-874.
DOI: https://doi.org/10.3341/jkos.2010.51.6.865    Published online June 15, 2010.
Economic Evaluation of Different Initial Treatments for Primary Open Angle Glaucoma: A Markov Model.
Tong Yun Kwag, Jee Hyun Kwag, Yeon Deok Kim, Hye Bin Yim, Hae Jung Paik, Chi Jun Park, Aman Shah B Abdul Majid, Kui Dong Kang
1Oxford Eye Hospital, Oxford University, Oxford, UK. kuidongkang@gmail.com
2Department of Brain and Cognitive Engineering, Korea University, Seoul, Korea.
3Glaucoma and Cataract Services, HanGil Eye Hospital, Incheon, Korea.
4Department of Ophthalmology, The Catholic University of Korea, School of Medicine, Seoul, Korea.
5Department of Ophthalmology, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Korea.
6Department of Computer Engineering, Hongik University, Seoul, Korea.
원발개방각녹내장 환자에서 일차 치료 방법에 따른 비용과 분포 비교
곽동윤1ㆍ곽지현2ㆍ김연덕3ㆍ임혜빈4ㆍ백혜정5ㆍ박치준6ㆍAman Shah B. Abdul Majid1ㆍ강규동1,4
Oxford Eye Hospital, Oxford University1, Oxford, UK Department of Brain and Cognitive Engineering, Korea University2, Seoul, Korea Glaucoma and Cataract Services, HanGil Eye Hospital3, Incheon, Korea Department of Ophthalmology, The Catholic University of Korea, School of Medicine4, Seoul, Korea Department of Ophthalmology, Gachon University of Medicine and Science, Gil Medical Center5, Incheon, Korea Department of Computer Engineering, Hongik University6, Seoul, Korea
Abstract
PURPOSE
To perform an economic evaluation of the different treatment methods available for primary open-angle glaucoma in a Korean setting, including medication, selective laser trabeculoplasty, or surgery. METHODS: Three independent Markov chains were constructed for each treatment option to simulate treatment progress and to evaluate the total treatment costs for each initial strategy. The Markov chain consisted of different stages (5, 10, 20 stages), with each stage being one year. Assuming 1000 patients, a Monte Carlo simulation was iterated 1000 times to evaluate the cost of treatment over 5, 10 and 20 years. RESULTS: During the initial five years, medication as the initial treatment was the most expensive, whereas laser trabeculoplasty was the cheapest. After ten years, surgery became the cheapest treatment. In ten years, if the success rate of surgery is greater than 30.1%, it was more economic to choose surgery as the initial treatment. For laser trabeculoplasty, if the success rate was greater than 16.3%, laser treatment was more economical than was medication. Our model shows that only if the annual cost of medication decreases to 60,000 won or 55,000 won, then the cost of choosing medication as the initial treatment strategy will be more economical than that of laser therapy or surgery, respectively. CONCLUSIONS: The economic value of choosing laser therapy as the initial treatment strategy is the greatest over five simulated-years, whereas surgery had the greatest economic value over more than ten years.
Key Words: Economic evaluation;Glaucoma;Laser trabeculoplasty;Markov model;Monte Carlo simulation


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