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Cost-effectiveness of the Boston keratoprosthesis.
Am J Ophthalmol. 2010 Feb; 149(2):221-228.e2.AJ

Abstract

PURPOSE

To conduct a cost-utility analysis and determine the cost-effectiveness of the Boston Keratoprosthesis (Boston Kpro).

DESIGN

Retrospective cohort study.

METHODS

setting: The Massachusetts Eye and Ear Infirmary corneal service. patients: Inclusion required a minimum 2-year follow-up. Patients with autoimmune diseases and chemical burns were excluded. Eighty-two patients were included with various indications for surgery. intervention: The keratoprosthesis is a collar button-shaped polymethylmethacrylate (PMMA) device consisting of 2 curved plates sandwiched around a corneal donor (allo)graft. The device is assembled intraoperatively and sutured to a patient's eye after removing the diseased cornea.

MAIN OUTCOME MEASURES

Average cost-effectiveness of the keratoprosthesis was determined by cost-utility analysis, using expected-value calculations and time-tradeoff utilities. The comparative effectiveness, or gain in quality-adjusted life years (QALYs), was also sought. Cost-effectiveness was compared to recently published data on penetrating keratoplasty (PK).

RESULTS

A total discounted incremental QALY gain for the Boston Kpro of 0.763 correlated with a conferred QALY gain of 20.3% for the average patient. The average cost-effectiveness of the keratoprosthesis was $16 140 per QALY.

CONCLUSIONS

Comparable to corneal transplantation, with a cost-effectiveness between $12 000 and $16 000 per QALY, the keratoprosthesis can be considered highly cost-effective.

Authors+Show Affiliations

Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA 02114-4724, USA. jared_ament@meei.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19939347

Citation

Ament, Jared D., et al. "Cost-effectiveness of the Boston Keratoprosthesis." American Journal of Ophthalmology, vol. 149, no. 2, 2010, pp. 221-228.e2.
Ament JD, Stryjewski TP, Ciolino JB, et al. Cost-effectiveness of the Boston keratoprosthesis. Am J Ophthalmol. 2010;149(2):221-228.e2.
Ament, J. D., Stryjewski, T. P., Ciolino, J. B., Todani, A., Chodosh, J., & Dohlman, C. H. (2010). Cost-effectiveness of the Boston keratoprosthesis. American Journal of Ophthalmology, 149(2), 221-e2. https://doi.org/10.1016/j.ajo.2009.08.027
Ament JD, et al. Cost-effectiveness of the Boston Keratoprosthesis. Am J Ophthalmol. 2010;149(2):221-228.e2. PubMed PMID: 19939347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of the Boston keratoprosthesis. AU - Ament,Jared D, AU - Stryjewski,Tomasz P, AU - Ciolino,Joseph B, AU - Todani,Amit, AU - Chodosh,James, AU - Dohlman,Claes H, Y1 - 2009/11/24/ PY - 2009/07/07/received PY - 2009/08/25/revised PY - 2009/08/26/accepted PY - 2009/11/27/entrez PY - 2009/11/27/pubmed PY - 2010/2/5/medline SP - 221 EP - 228.e2 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 149 IS - 2 N2 - PURPOSE: To conduct a cost-utility analysis and determine the cost-effectiveness of the Boston Keratoprosthesis (Boston Kpro). DESIGN: Retrospective cohort study. METHODS: setting: The Massachusetts Eye and Ear Infirmary corneal service. patients: Inclusion required a minimum 2-year follow-up. Patients with autoimmune diseases and chemical burns were excluded. Eighty-two patients were included with various indications for surgery. intervention: The keratoprosthesis is a collar button-shaped polymethylmethacrylate (PMMA) device consisting of 2 curved plates sandwiched around a corneal donor (allo)graft. The device is assembled intraoperatively and sutured to a patient's eye after removing the diseased cornea. MAIN OUTCOME MEASURES: Average cost-effectiveness of the keratoprosthesis was determined by cost-utility analysis, using expected-value calculations and time-tradeoff utilities. The comparative effectiveness, or gain in quality-adjusted life years (QALYs), was also sought. Cost-effectiveness was compared to recently published data on penetrating keratoplasty (PK). RESULTS: A total discounted incremental QALY gain for the Boston Kpro of 0.763 correlated with a conferred QALY gain of 20.3% for the average patient. The average cost-effectiveness of the keratoprosthesis was $16 140 per QALY. CONCLUSIONS: Comparable to corneal transplantation, with a cost-effectiveness between $12 000 and $16 000 per QALY, the keratoprosthesis can be considered highly cost-effective. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/19939347/Cost_effectiveness_of_the_Boston_keratoprosthesis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(09)00627-8 DB - PRIME DP - Unbound Medicine ER -