EE105 Triamcinolone Acetonide Injectable Suspension, for Suprachoroidal Use, for the Treatment of Macular Edema Associated with Uveitis in the United States: A Budget Impact Analysis

Triamcinolone acetonide injectable suspension, for suprachoroidal use, has recently received FDA approval to treat macular edema (ME) associated with uveitis (specifically non-infectious uveitis; NIU) in the US. The objective of this study was to assess the budget impact of the drug for the treatment of ME associated with NIU from a US third-party payer perspective (Commercial and Medicare). A budget impact model over a 5-year time horizon was developed using Microsoft® Excel comparing the total costs required to treat patients with ME associated with NIU in two scenarios: with and without triamcinolone acetonide injectable suspension, for suprachoroidal use. Model inputs (epidemiological and cost inputs: pharmacy costs, eye-related inpatient, outpatient, emergency department [ED] visit and non-eye related costs stratified by severity of vision loss) were obtained from the published literature that estimated these inputs using Truven MarketScan® database and Medicare 5% sample. One-way sensitivity and scenario analyses were considered as per the ISPOR 2014 BIA Best Practice Guidelines. The introduction of triamcinolone acetonide injectable suspension, for suprachoroidal use, at a wholesale acquisition cost of $1,650/injection (plus admin cost of $200/injection) was cost-neutral for both Commercial and Medicare plans. Total plan level budget impact was estimated to be $2.6K and $38.3K per million members for Commercial and Medicare plan lives, respectively. The per member per month (PMPM) costs were less than a cent across Commercial and Medicare plans. Sensitivity analysis by varying several parameters like cost of vision loss, number of injections year 2 onwards etc., suggested that cost-neutrality was maintained under alternative model assumptions. Introduction of triamcinolone acetonide injectable suspension, for suprachoroidal use, for treatment of ME associated with NIU in the US, could lead to lower eye-related (inpatient, outpatient, ED), non-eye related, and pharmacy costs, benefitting the US healthcare system.