TearCare system versus cyclosporine ophthalmic emulsion for the treatment of moderate-to-severe meibomian gland disease associated dry eye disease in the United States: a cost-utility analysis

Abstract

Background: Meibomian gland disease (MGD) is a leading cause of dry eye disease (DED), yet current treatments like over-the-counter and prescription drops do not address this root cause. TearCare is an FDA-cleared, in-office procedure that directly targets MGD, but its cost-effectiveness has not been previously evaluated. Research design and methods: We conducted a cost-utility analysis (CUA) comparing TearCare with topical cyclosporine 0.05% (CsA) for moderate-to-severe MGD-related DED. A U.S. payer perspective and 1-year time horizon were used. A Markov model with 3-month cycles evaluated transitions across four Ocular Surface Disease Index (OSDI)-defined health states. Transition probabilities and persistence rates were derived from the SAHARA trial and literature. Results: TearCare provided better outcomes (e.g. more patients improving to mild/no symptoms) and was less costly ($4,916 vs $5,819), with a quality-adjusted life year (QALY) gain of 0.014. This corresponds to approximately 5.1 additional days in perfect health over 1 year. The incremental cost-effectiveness ratio (ICER) showed TearCare to be dominant (more effective and less costly). Conclusions: TearCare is a cost-effective treatment for MGD-related DED, offering both clinical benefits and cost savings over CsA.