Rev Bras Oftalmol.2025;84:e0072
Real-world savings in medication-related costs up to 5 years with the use of the second-generation trabecular implant (iStent inject®) in mild open-angle glaucoma
DOI: 10.37039/1982.8551.20250072
ABSTRACT
Objective:
To assess medication-related costs in patients with open-angle glaucoma subjected to iStent inject®.
Methods:
Retrospective study of patients with early-stage open-angle glaucoma who underwent iStent inject® implantation within the Brazilian private healthcare system and were followed for a period of 1 to 5 years. The study population comprised 234 patients with a mean age of 68.4 years old. The capacity to reduce intraocular pressure, amount of antiglaucoma medications required, and monthly cost of the necessary antiglaucoma medications during follow-up were evaluated. The accumulated cost of medications over 5 years was also calculated. The results obtained (Group 1 – iStent inject®) were compared with the theoretical cost of maintaining the same medication regimen from baseline (Group 2 – Medications). A theoretical extrapolation of the costs to the Brazilian public healthcare system was also performed.
Results:
The study population consisted of 234 patients with a mean age of 68.4 years old. Mean intraocular pressure and medication reductions from baseline to final follow-up were 15.4 and 76.2%, respectively. At baseline, 70.1% of eyes used two or more medications, while 73.1% were medication-free by the end of follow-up. An 80% sustained reduction in monthly medication costs was observed. The mean accumulated 5-year medication-related costs (US dollars) per patient in Groups 1 and 2 were $555.94 and $3,160.79, respectively, in the private sector and $100.42 and $512.82, respectively, in the public sector.
Conclusion:
In this real-world analysis, iStent inject® implantation significantly reduced both medication use and related costs over a 5-year period. These findings suggest a potential long-term economic benefit for healthcare systems, especially when managing early-stage open-angle glaucoma.
