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Budget impact model of Mydrane®, a new intracameral injectable used for intra-operative mydriasis, from a UK hospital perspective.

Abstract During cataract surgery, maintaining an adequate degree of mydriasis throughout the entire operation is critical to allow for visualisation of the capsulorhexis and the crystalline lens. Good anaesthesia is also essential for safe intraocular surgery. Mydrane® is a new injectable intracameral solution containing two mydriatics (tropicamide 0.02% and phenylephrine 0.31%) and one anaesthetic (lidocaine 1%) that was developed as an alternative to the conventional topical pre-operative mydriatics used in cataract surgery. This study aimed to estimate the budget impact across a one year time frame using Mydrane® instead of topical dilating eye drops, for a UK hospital performing 3,000 cataract operations a year.
PMID
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Authors

Mayor MeshTerms

Cost-Benefit Analysis

Keywords

Anaesthesia

Budget impact model

Cataract surgery

Mydriasis

Mydriatics

Journal Title bmc ophthalmology
Publication Year Start




PMID- 29673317
OWN - NLM
STAT- MEDLINE
DCOM- 20180430
LR  - 20180501
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 18
IP  - 1
DP  - 2018 Apr 19
TI  - Budget impact model of Mydrane(R), a new intracameral injectable used for
      intra-operative mydriasis, from a UK hospital perspective.
PG  - 104
LID - 10.1186/s12886-018-0746-x [doi]
AB  - BACKGROUND: During cataract surgery, maintaining an adequate degree of mydriasis 
      throughout the entire operation is critical to allow for visualisation of the
      capsulorhexis and the crystalline lens. Good anaesthesia is also essential for
      safe intraocular surgery. Mydrane(R) is a new injectable intracameral solution
      containing two mydriatics (tropicamide 0.02% and phenylephrine 0.31%) and one
      anaesthetic (lidocaine 1%) that was developed as an alternative to the
      conventional topical pre-operative mydriatics used in cataract surgery. This
      study aimed to estimate the budget impact across a one year time frame using
      Mydrane(R) instead of topical dilating eye drops, for a UK hospital performing
      3,000 cataract operations a year. METHODS: A budget impact model (BIM) was
      developed to compare the economic outcomes associated with the use of Mydrane(R) 
      versus topical drops (tropicamide 0.5% and phenylephrine 10%) in patients
      undergoing cataract surgery in a UK hospital. The outcomes of interest included
      costs and resource use (e.g. clinician time, mydriasis failures, operating room
      time, number of patients per vial of therapy etc.) associated with management of 
      mydriasis in patients undergoing cataract surgery. All model inputs considered
      the UK hospital perspective without social or geographical variables.
      Deterministic sensitivity analyses were also performed to assess the model
      uncertainty. RESULTS: Introduction of Mydrane(R) is associated with a cost saving
      of pound6,251 over 3,000 cataract surgeries in one year. The acquisition costs of
      the Mydrane(R) ( pound18,000 by year vs. pound3,330 for eye drops) were balanced 
      by substantial reductions in mainly nurses' costs and time, plus a smaller
      contribution from savings in surgeons' costs ( pound20,511) and lower costs
      associated with auxiliary dilation ( pound410 due to avoidance of additional
      dilation methods). Results of the sensitivity analyses confirmed the robustness
      of the model to the variation of inputs. Except for the duration of one session
      of eye drop instillation and the cost of Mydrane(R), Mydrane(R) achieved an
      incremental cost gain compared to tropicamide/phenylephrine eye drops.
      CONCLUSIONS: Despite a higher acquisition cost of Mydrane(R), the budget impact
      of Mydrane(R) on hospital budgets is neutral. Mydrane(R) offers a promising
      alternative to traditional regimes using eye drops, allowing for a better patient
      flow and optimisation of the surgery schedule with neutral budget impact.
FAU - Davey, Keith
AU  - Davey K
AD  - Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK.
      [email protected]
FAU - Chang, Bernard
AU  - Chang B
AD  - Leeds Teaching Hospitals NHS Trust, Leeds, UK.
FAU - Purslow, Christine
AU  - Purslow C
AD  - Thea Pharmaceuticals, Keele, UK.
FAU - Clay, Emilie
AU  - Clay E
AD  - Creativ-Ceutical, Paris, France.
FAU - Vataire, Anne-Lise
AU  - Vataire AL
AD  - Creativ-Ceutical, Paris, France.
LA  - eng
PT  - Journal Article
DEP - 20180419
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (Anesthetics, Local)
RN  - 0 (Mydriatics)
RN  - 1WS297W6MV (Phenylephrine)
RN  - 98PI200987 (Lidocaine)
RN  - N0A3Z5XTC6 (Tropicamide)
SB  - IM
MH  - Anesthetics, Local/administration & dosage
MH  - Budgets
MH  - *Cost-Benefit Analysis
MH  - Drug Costs
MH  - Hospital Costs
MH  - Humans
MH  - Lidocaine/administration & dosage
MH  - Models, Economic
MH  - Mydriasis/*economics
MH  - Mydriatics/administration & dosage/*economics
MH  - Phacoemulsification/economics/*methods
MH  - Phenylephrine/administration & dosage/*economics
MH  - Prospective Studies
MH  - Tropicamide/administration & dosage/*economics
MH  - United Kingdom
PMC - PMC5907706
OTO - NOTNLM
OT  - Anaesthesia
OT  - Budget impact model
OT  - Cataract surgery
OT  - Mydriasis
OT  - Mydriatics
EDAT- 2018/04/21 06:00
MHDA- 2018/05/01 06:00
CRDT- 2018/04/21 06:00
PHST- 2016/12/22 00:00 [received]
PHST- 2018/03/16 00:00 [accepted]
PHST- 2018/04/21 06:00 [entrez]
PHST- 2018/04/21 06:00 [pubmed]
PHST- 2018/05/01 06:00 [medline]
AID - 10.1186/s12886-018-0746-x [doi]
AID - 10.1186/s12886-018-0746-x [pii]
PST - epublish
SO  - BMC Ophthalmol. 2018 Apr 19;18(1):104. doi: 10.1186/s12886-018-0746-x.