Avaliação econômica do tratamento do glaucoma primário de ângulo aberto no Brasil: um estudo de custo-utilidade sob a perspectiva da sociedade

Abstract

Glaucoma is a chronic disease and its predominant type, primary open-angle glaucoma, is genetic, so its primary prevention is still infeasible in practice.Key actions to slow the spread of the disease are focused on early diagnosis and effective treatment. Treatment and control of the disease can be done through surgery, laser or eye drops. With the aging of the world population and the increasing costs of treating glaucoma, a cost-effective allocation of resources is necessary in the treatment and control of primary open-angle glaucoma. The objective of this study is to evaluate the comparative efficiency of the treatment of primary open angle glaucoma in Brazil, by evaluating the cost-utility of several treatment strategies taking into account the direct and indirect costs. The cost-utility study was based on the Markov model. Three treatment strategies were tested: no treatment, initial treatment with eye drops and initial treatment with laser trabeculoplasty. The measure of outcome was the incremental cost-utility ratio and the robustness of the model was tested through sensitivity analysis. Of the strategies tested, the initial treatment with eye drops was the most cost-effective and dominant over the others. It was concluded that both laser trabeculoplasty and medications as primary treatments of primary open-angle glaucoma generated significant gains in quality of life. The initial treatment alternative through laser trabeculoplasty was not cost-effective.