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Topical cyclosporine improves quality of life, is cost-effective for dry eye patients
Arch Ophthalmol. 2009;127(2):146-152.
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Topical cyclosporine emulsion 0.05% improved quality of life and proved cost-effective for patients with moderate to severe dry eye syndrome that did not respond to conventional therapy.
Dry eye patients have more difficulty reading, working, using a computer, watching television and driving than those without the disease, the study authors said.
"The burden of dry eye disease from both the prevalence and patient morbidity standpoints makes this a sizeable public health dilemma," they said.
Investigators used data from two randomized 6-month U.S. Food and Drug Administration clinical trials for Restasis (cyclosporine emulsion 0.05%, Allergan). The study cohort included 877 patients who had a mean age of 58.7 years.
Total value gain, or comparative effectiveness, was assessed in terms of quality-adjusted life-year (QALY) gain and percentage of improvement in quality of life. Cost-effectiveness was a cost-utility ratio using dollars per QALY, the authors said.
Cyclosporine afforded a value gain of 0.0319 QALY per year, a 4.3% quality-of-life improvement compared with cyclosporine vehicle therapy and a 7.1% improvement compared with no treatment.
Cost-utility analysis showed topical cyclosporine below $50,000 per QALY, which is considered very cost-effective in the U.S. Accounting for average cost-utility ratios, the cost of topical cyclosporine could increase up to 372% and remain cost-effective. Interventions with a cost-utility ratio of $100,000 per QALY or more are not considered cost-effective, the authors said.