Williams, Andrew MTheophanous, ChristosMuir, Kelly WRosdahl, Jullia AWoolson, SandraOlsen, MarenBosworth, Hayden BHung, Anna2024-01-022024-01-022022-120002-93941879-1891https://hdl.handle.net/10161/29619<h4>Purpose</h4>To assess the within-trial cost-effectiveness of a behavioral intervention to improve glaucoma medication adherence.<h4>Design</h4>Prospective cost-effectiveness analysis of randomized, controlled trial data.<h4>Methods</h4>The study setting was a Veterans Affairs (VA) eye clinic. The patient population comprised veterans with medically treated glaucoma and self-reported poor adherence. Participants were randomized to a personalized educational session with a reminder bottle to promote medication adherence or to a control session on general eye health. Costs were assessed from the perspective of the VA payor at 6 months using the VA Managerial Cost Accounting System. Probabilistic sensitivity analyses were conducted using bootstrapped samples. The main outcome measures were the proportion of participants attaining ≥80% adherence as measured by electronic monitor, total intervention and medical resource costs, and incremental cost-effectiveness ratios comparing intervention to control at 6 months.<h4>Results</h4>Of 200 randomized participants, 95 of 100 assigned to the intervention and 97 of 100 assigned to the control had adherence outcomes at 6 months, and the proportion of adherent patients was higher in the intervention group compared to control (0.78 vs 0.40, P < .0001). All participants had costs at 6 months. The total cost at 6 months was $1,149,600 in the intervention group (n = 100) compared to $1,298,700 in the control group (n = 100). Thus, in a hypothetical cohort of 100 patients, the intervention was associated with cost savings (-$149,100) and resulted in 38 additional patients achieving medication adherence.<h4>Conclusions</h4>An adherence-enhancing behavioral intervention was effective and cost saving at 6 months.HumansGlaucomaCohort StudiesProspective StudiesCost-Benefit AnalysisMedication AdherenceJournal article