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ALT, medical therapy most cost-effective treatments for early glaucoma patients

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ATLANTA — Argon laser trabeculoplasty and medical therapy are cost-effective treatments for early glaucoma patients, with trabeculectomy ranking third in cost-effectiveness, an expert said here.

Steven M. Kymes

"Both ALT and topical medication meet accepted standards of cost-effectiveness as first-line therapies," Steven M. Kymes, PhD, MHA, said at the American Academy of Ophthalmology meeting.

Dr. Kymes and colleagues established a model using a microsimulation approach to estimate the cost-effectiveness of three glaucoma treatment options. They found that patients who were expected to live another 13.4 years would spend more on medications ($9,328) than laser ($8,359).

The estimated net cost of medication over laser surgery was $72 a year, Dr. Kymes said. He said indications for filtration surgery, even in moderate glaucoma patients, show it as a second-line treatment option in terms of cost-effectiveness.

He said the decision for first-line glaucoma treatment may be depend on ability to pay. For instance, in regions where medical therapy is not as affordable, ALT may be the best first-line treatment.