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Incremental cost-effectiveness of initial cataract surgery.
Ophthalmology. 2002 Mar; 109(3):606-12; discussion 612-3.O

Abstract

PURPOSE

The purpose of this study was to perform a reference case, cost-utility analysis of initial cataract surgery using the current literature on cataract outcomes and complications.

DESIGN

Computer-based econometric modeling.

METHODS

Visual acuity data of patients treated and observed over a 4-month postoperative period was obtained from the US National Cataract Patient Outcomes Research Team (PORT). The results from this prospective study were combined with other studies that investigated the complication rates of cataract surgery to complete the cohort of patients and outcomes. These synthesized data were incorporated with time-tradeoff utility values, decision analysis, and econometric modeling to account for the time value of money.

MAIN OUTCOME MEASURES

The number of quality-adjusted life-years (QALYs) gained was calculated for the study group undergoing cataract extraction in the first eye when the vision was the same in both eyes. This was divided into the cost of the procedure to find the year 2000 nominal US dollars spent per quality-adjusted life-year ($/QALY) gained.

RESULTS

Initial cataract surgery, compared with observation, resulted in a mean gain of 1.776 QALYs per patient treated. A 3% annual discount rate was used to account for the benefit over time, yielding 1.25 QALYs gained. The mean cost of treatment (also discounted at a 3% annual rate) of each patient totaled 2525 US dollars. The cost divided by the discounted benefit resulted in $2020/QALY gained for this procedure.

CONCLUSIONS

Initial cataract surgery seems to be highly cost-effective compared with procedures across multiple medical specialties. This information, incorporating patient preferences into evidenced-based medicine, will play an increasingly important role in the evaluation of health care in the future.

Authors+Show Affiliations

Center for Evidence-Based Health Care Economics, Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11874769

Citation

Busbee, Brandon G., et al. "Incremental Cost-effectiveness of Initial Cataract Surgery." Ophthalmology, vol. 109, no. 3, 2002, pp. 606-12; discussion 612-3.
Busbee BG, Brown MM, Brown GC, et al. Incremental cost-effectiveness of initial cataract surgery. Ophthalmology. 2002;109(3):606-12; discussion 612-3.
Busbee, B. G., Brown, M. M., Brown, G. C., & Sharma, S. (2002). Incremental cost-effectiveness of initial cataract surgery. Ophthalmology, 109(3), 606-12; discussion 612-3.
Busbee BG, et al. Incremental Cost-effectiveness of Initial Cataract Surgery. Ophthalmology. 2002;109(3):606-12; discussion 612-3. PubMed PMID: 11874769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incremental cost-effectiveness of initial cataract surgery. AU - Busbee,Brandon G, AU - Brown,Melissa M, AU - Brown,Gary C, AU - Sharma,Sanjay, PY - 2002/3/5/pubmed PY - 2002/3/22/medline PY - 2002/3/5/entrez SP - 606-12; discussion 612-3 JF - Ophthalmology JO - Ophthalmology VL - 109 IS - 3 N2 - PURPOSE: The purpose of this study was to perform a reference case, cost-utility analysis of initial cataract surgery using the current literature on cataract outcomes and complications. DESIGN: Computer-based econometric modeling. METHODS: Visual acuity data of patients treated and observed over a 4-month postoperative period was obtained from the US National Cataract Patient Outcomes Research Team (PORT). The results from this prospective study were combined with other studies that investigated the complication rates of cataract surgery to complete the cohort of patients and outcomes. These synthesized data were incorporated with time-tradeoff utility values, decision analysis, and econometric modeling to account for the time value of money. MAIN OUTCOME MEASURES: The number of quality-adjusted life-years (QALYs) gained was calculated for the study group undergoing cataract extraction in the first eye when the vision was the same in both eyes. This was divided into the cost of the procedure to find the year 2000 nominal US dollars spent per quality-adjusted life-year ($/QALY) gained. RESULTS: Initial cataract surgery, compared with observation, resulted in a mean gain of 1.776 QALYs per patient treated. A 3% annual discount rate was used to account for the benefit over time, yielding 1.25 QALYs gained. The mean cost of treatment (also discounted at a 3% annual rate) of each patient totaled 2525 US dollars. The cost divided by the discounted benefit resulted in $2020/QALY gained for this procedure. CONCLUSIONS: Initial cataract surgery seems to be highly cost-effective compared with procedures across multiple medical specialties. This information, incorporating patient preferences into evidenced-based medicine, will play an increasingly important role in the evaluation of health care in the future. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/11874769/Incremental_cost_effectiveness_of_initial_cataract_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(01)00971-X DB - PRIME DP - Unbound Medicine ER -