Economic Impact Of Moderate And Severe Neurotrophic Keratitis In Italy

OBJECTIVES: Neurotrophic keratitis (NK) is a rare corneal degenerative disease caused by impaired corneal innervation. Available research suggests Italian incidence and prevalence rates below 1.6/10,000 (Sacchetti and Lambiase, 2014). There is general paucity of evidence and no published economic st...

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Bibliographic Details
Published in:Value in health 2017-10, Vol.20 (9), p.A552
Main Authors: Stanisic, S, Marocco, A, Gallo, A, Pedrotti, E, Rama, P, Sachetti, M, Mascia, M, Mazzamuto, LR, Prisco, L, Van Nooten, F, Berto, P
Format: Article
Language:English
Subjects:
Antibiotics
Clinical medicine
Clinical outcomes
Contact lenses
Cornea
Corneal transplantation
Corticosteroids
Economic impact
Eye diseases
Health care expenditures
Health services
Indirect costs
Innervation
Inpatient care
Keratitis
Medical treatment
Patients
Payments
Personal expenditure
Prescription drugs
Prices
Severity
Tariffs
Tears
Ulcers
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Summary:OBJECTIVES: Neurotrophic keratitis (NK) is a rare corneal degenerative disease caused by impaired corneal innervation. Available research suggests Italian incidence and prevalence rates below 1.6/10,000 (Sacchetti and Lambiase, 2014). There is general paucity of evidence and no published economic studies of NK in the local or international literature. This is a first attempt to assess the economic impact of moderate (persistent epithelial defect, PED) and severe (corneal ulcer, CU) NK from the national health system (NHS) and societal perspectives in Italy (cost year 2017). METHODS: Treatment algorithm and health resource use were estimated in a survey of 9 large national referral centres, specialized in corneal conditions, across Italy. Centre representatives reported information from local clinical practice; national ambulatory and inpatient tariffs were applied to units of service, and AIFA published prices to pharmaceuticals. Mean annual per patient cost was derived as average cost weighted by proportion of patients on each respective treatment and length of treatment. Societal perspective included patients' out-of-pocket payments and societal remuneration for eye functional loss, as a consequence of NK. RESULTS: Estimated mean annual cost of treatment for the Italian NHS was €5,167 and €10,885 per PED and CU NK patient, respectively. Costs were largely driven by costs of visits, ambulatory and hospital interventions such as temporary/permanent tarsorrhaphy, amniotic-membrane transplant, conjunctival flap and corneal transplant. Estimated mean annual cost from the societal perspective was €5,788 and €11,730 per PED and CU NK patients. This included cost of out-of pocket payments for artificial tears, antibiotic and corticosteroid drops, therapeutic contact lenses and estimated mean remuneration per functional eye loss. CONCLUSIONS: Mean annual cost of NK in the Italian setting increases by twofold with disease severity. Further research is warranted to provide more insight especially into indirect costs.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.08.873