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A value-based medicine cost-utility analysis of idiopathic epiretinal membrane surgery.
Am J Ophthalmol. 2008 May; 145(5):923-8.AJ

Abstract

PURPOSE

To perform a reference case, cost-utility analysis of epiretinal membrane (ERM) surgery using current literature on outcomes and complications.

DESIGN

Computer-based, value-based medicine analysis.

METHODS

Decision analyses were performed under two scenarios: ERM surgery in better-seeing eye and ERM surgery in worse-seeing eye. The models applied long-term published data primarily from the Blue Mountains Eye Study and the Beaver Dam Eye Study. Visual acuity and major complications were derived from 25-gauge pars plana vitrectomy studies. Patient-based, time trade-off utility values, Markov modeling, sensitivity analysis, and net present value adjustments were used in the design and calculation of results. Main outcome measures included the number of discounted quality-adjusted-life-years (QALYs) gained and dollars spent per QALY gained.

RESULTS

ERM surgery in the better-seeing eye compared with observation resulted in a mean gain of 0.755 discounted QALYs (3% annual rate) per patient treated. This model resulted in $4,680 per QALY for this procedure. When sensitivity analysis was performed, utility values varied from $6,245 to $3,746/QALY gained, medical costs varied from $3,510 to $5,850/QALY gained, and ERM recurrence rate increased to $5,524/QALY. ERM surgery in the worse-seeing eye compared with observation resulted in a mean gain of 0.27 discounted QALYs per patient treated. The $/QALY was $16,146 with a range of $20,183 to $12,110 based on sensitivity analyses. Utility values ranged from $21,520 to $12,916/QALY and ERM recurrence rate increased to $16,846/QALY based on sensitivity analysis.

CONCLUSIONS

ERM surgery is a very cost-effective procedure when compared with other interventions across medical subspecialties.

Authors+Show Affiliations

Retina Service, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA. ogupta1@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

18329000

Citation

Gupta, Omesh P., et al. "A Value-based Medicine Cost-utility Analysis of Idiopathic Epiretinal Membrane Surgery." American Journal of Ophthalmology, vol. 145, no. 5, 2008, pp. 923-8.
Gupta OP, Brown GC, Brown MM. A value-based medicine cost-utility analysis of idiopathic epiretinal membrane surgery. Am J Ophthalmol. 2008;145(5):923-8.
Gupta, O. P., Brown, G. C., & Brown, M. M. (2008). A value-based medicine cost-utility analysis of idiopathic epiretinal membrane surgery. American Journal of Ophthalmology, 145(5), 923-8. https://doi.org/10.1016/j.ajo.2007.12.037
Gupta OP, Brown GC, Brown MM. A Value-based Medicine Cost-utility Analysis of Idiopathic Epiretinal Membrane Surgery. Am J Ophthalmol. 2008;145(5):923-8. PubMed PMID: 18329000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A value-based medicine cost-utility analysis of idiopathic epiretinal membrane surgery. AU - Gupta,Omesh P, AU - Brown,Gary C, AU - Brown,Melissa M, Y1 - 2008/03/10/ PY - 2007/09/20/received PY - 2007/12/23/revised PY - 2007/12/31/accepted PY - 2008/3/11/pubmed PY - 2008/5/21/medline PY - 2008/3/11/entrez SP - 923 EP - 8 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 145 IS - 5 N2 - PURPOSE: To perform a reference case, cost-utility analysis of epiretinal membrane (ERM) surgery using current literature on outcomes and complications. DESIGN: Computer-based, value-based medicine analysis. METHODS: Decision analyses were performed under two scenarios: ERM surgery in better-seeing eye and ERM surgery in worse-seeing eye. The models applied long-term published data primarily from the Blue Mountains Eye Study and the Beaver Dam Eye Study. Visual acuity and major complications were derived from 25-gauge pars plana vitrectomy studies. Patient-based, time trade-off utility values, Markov modeling, sensitivity analysis, and net present value adjustments were used in the design and calculation of results. Main outcome measures included the number of discounted quality-adjusted-life-years (QALYs) gained and dollars spent per QALY gained. RESULTS: ERM surgery in the better-seeing eye compared with observation resulted in a mean gain of 0.755 discounted QALYs (3% annual rate) per patient treated. This model resulted in $4,680 per QALY for this procedure. When sensitivity analysis was performed, utility values varied from $6,245 to $3,746/QALY gained, medical costs varied from $3,510 to $5,850/QALY gained, and ERM recurrence rate increased to $5,524/QALY. ERM surgery in the worse-seeing eye compared with observation resulted in a mean gain of 0.27 discounted QALYs per patient treated. The $/QALY was $16,146 with a range of $20,183 to $12,110 based on sensitivity analyses. Utility values ranged from $21,520 to $12,916/QALY and ERM recurrence rate increased to $16,846/QALY based on sensitivity analysis. CONCLUSIONS: ERM surgery is a very cost-effective procedure when compared with other interventions across medical subspecialties. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/18329000/A_value_based_medicine_cost_utility_analysis_of_idiopathic_epiretinal_membrane_surgery_ DB - PRIME DP - Unbound Medicine ER -