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Evidence from randomized clinical trials was identified for four different MIGS methods. A disease-transition model was developed by capturing clinically relevant POAG stages and the expected natural disease evolution. Outcomes of the disease-transition model were the comparative utility [quality-adjusted life years (QALYs)], cost and cost\u2013utility of included strategies in a lifetime horizon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Estimated 1-year IOP reductions were: cataract surgery \u2212\u20092.05\u00a0mmHg (95% CI \u2212\u20093.38; \u2212\u20090.72), one trabecular micro-bypass stent \u2212\u20093.15\u00a0mmHg (95% CI \u2212\u20095.66; \u2212\u20090.64), two trabecular micro-bypass stents \u2212\u20094.85\u00a0mmHg (95% CI \u2212\u20097.71; \u2212\u20091.99) and intracanalicular scaffold \u2212\u20092.25\u00a0mmHg (95% CI \u2212\u20094.87; 0.37). Discounted outcomes from the disease-transition model appraised the strategy of two trabecular micro-bypass stents with cataract surgery in the moderate POAG stage as the one providing the greatest added value, with 10,955\u20ac per additional QALY. Improved outcomes were seen when assessing MIGS in the moderate POAG stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When indirectly comparing alternative MIGS methods combined with cataract surgery, the option of two trabecular micro-bypass stents showed both a superior efficacy and long-term cost\u2013utility from a German perspective. Moreover, outcomes of the disease-transition model suggest POAG patients to beneficiate the most from an earlier intervention in the moderate stage contrary to waiting until an advanced disease is present.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s10792-020-01314-7","type":"journal-article","created":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T11:02:34Z","timestamp":1584442954000},"page":"1469-1479","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Comparative efficacy and cost\u2013utility of combined cataract and minimally invasive glaucoma surgery in primary open-angle glaucoma"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2775-393X","authenticated-orcid":false,"given":"Jose","family":"Bartelt-Hofer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Flessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"issue":"11","key":"1314_CR1","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","volume":"121","author":"YC Tham","year":"2014","unstructured":"Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. 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