The cost-effectiveness of the Argus II retinal prosthesis in Retinitis Pigmentosa patients

• Published in: BMC ophthalmology 2014-04, Vol.14 (1), p.49-49, Article 49
• Main Authors: Vaidya, Anil, Borgonovi, Elio, Taylor, Rod S, Sahel, José-Alain, Rizzo, Stanislao, Stanga, Paulo Eduardo, Kukreja, Amit, Walter, Peter
• Format: Article
• Language: English
• Subjects: Cost benefit analysis; Economic aspects; Female; Follow-Up Studies; Health Care Costs; Humans; Markov Chains; Medical research; Medicine, Experimental; Middle Aged; Models, Statistical; Ophthalmology; Prostheses and Implants - economics; Quality-Adjusted Life Years; Retinitis Pigmentosa - economics; Retinitis Pigmentosa - surgery
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/1471-2415-14-49

Retinitis Pigmentosa (RP) is a hereditary genetic disease causing bilateral retinal degeneration. RP is a leading cause of blindness resulting in incurable visual impairment and drastic reduction in the Quality of life of the patients. Second Sight Medical Products Inc. developed Argus II, a retinal prosthesis system for treating RP. Argus II is the world's first ever-commercial implant intended to restore some vision in the blind patients. The objective of this study was to assess the cost-effectiveness of the Argus® II Retinal Prosthesis System (Argus II) in Retinitis Pigmentosa (RP) patients. A multi -state transition Markov model was developed to determine the cost-effectiveness of Argus II versus usual care in RP from the perspective of healthcare payer. A hypothetical cohort of 1000 RP patients aged 46 years followed up over a (lifetime) 25-year time horizon. Health outcomes were expressed as quality adjusted life years (QALYs) and direct healthcare costs expressed in 2012 €. Results are reported as incremental cost per ratios (ICERs) with outcomes and costs discounted at an annual rate of 3.5%. The ICER for Argus II was €14,603/QALY. Taking into account the uncertainty in model inputs the ICER was €14,482/QALY in the probabilistic analysis. In the scenarios of an assumption of no reduction on cost across model visual acuity states or a model time horizon as short as 10 years the ICER increased to €31,890/QALY and €49,769/QALY respectively. This economic evaluation shows that Argus II is a cost-effective intervention compared to usual care of the RP patients. The lifetime analysis ICER for Argus II falls below the published societal willingness to pay of EuroZone countries.