ECONOMIC ASPECTS OF THERAPEUTIC EYELID HYGIENE IN MEIBOMIAN GLAND DYSFUNCTION TREATMENT

The value of dry eye for general public health increases due to its high occurence in elderly persons and aging population. Non-specific questionnaires are adopted for dry eye. Additionally, 36‑item Medical Outcomes Study-Short Form (MOS-SF-36) and benefit evaluation method were developed. Methods. Information analysis and mathematical methods and public health technology evaluation methods (i.e., modelling, analysis of disease burden, and budget impact analysis) were applied to economic aspect study. Decision tree model based on these finding was developed and applied to cost estimating of blepharoconjunctival and exogenous dry eye treatment in computer vision syndrome. Two scenarios of patient management were considered, i.e., typical management and management using therapeutic eyelid hygiene. Similar model was developed for early postoperative period after LASIK. Short-run analysis (1 year) was performed, direct medical costs were considered. This analysis implies the calculation of overall cost (economic burden) of the disease. Official data on adult population size in 2014 and the occurrence of the disease were used to assess prevalence. Budget impact analysis evaluates the difference in total economic effects due to comparison technology use in money terms. Sensitivity analysis assesses the stability of simulation results. Medical treatment cost was considered the most valuable parameter. Results and conclusions. Direct medical costs of typical management and management using therapeutic eyelid hygiene in demodicosis, computer vision syndrome, and after LASIK were 14,623 RUB and 9,200 RUB (savings of 37 %), 17,630 RUB and 9,200 RUB (savings of 47 %), 4,425.5 RUB and 3,004 RUB (savings of 32 %), respectively. Analysis of economic burden with respect to disease occurrence and typical management costs demonstrated that in 2015 this parameter was estimated as 576,198,416,556 RUB. In terms of direct medical costs, therapeutic eyelid hygiene saves 44 % (on average).

dry eye, resulting medical parameters, economic aspects, modeling, disease burden analysis, budget impact analysis

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