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Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands.
J Cataract Refract Surg. 2019 02; 45(2):146-152.JC

Abstract

PURPOSE

To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (IOL) implantation in cataract patients with bilateral corneal astigmatism.

SETTING

Two ophthalmology clinics in the Netherlands.

DESIGN

Prospective cost-effectiveness analysis.

METHODS

Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio.

RESULTS

The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group (€3203 [$3864]) than in the monofocal IOL group (€2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P = .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of €2500 to €20 000 per QALY.

CONCLUSIONS

From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered.

Authors+Show Affiliations

University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: rob.simons@mumc.nl.University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.University Eye Clinic Maastricht, Maastricht University Medical Centre+, Maastricht, the Netherlands.Department of Clinical Epidemiology and Medical Technology Assessment, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre+, Maastricht, the Netherlands.

Pub Type(s)

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

Language

eng

PubMed ID

30471848

Citation

Simons, Rob W P., et al. "Trial-based Cost-effectiveness Analysis of Toric Versus Monofocal Intraocular Lenses in Cataract Patients With Bilateral Corneal Astigmatism in the Netherlands." Journal of Cataract and Refractive Surgery, vol. 45, no. 2, 2019, pp. 146-152.
Simons RWP, Visser N, van den Biggelaar FJHM, et al. Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands. J Cataract Refract Surg. 2019;45(2):146-152.
Simons, R. W. P., Visser, N., van den Biggelaar, F. J. H. M., Nuijts, R. M. M. A., Webers, C. A. B., Bauer, N. J. C., Beckers, H. J. M., & Dirksen, C. D. (2019). Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands. Journal of Cataract and Refractive Surgery, 45(2), 146-152. https://doi.org/10.1016/j.jcrs.2018.09.019
Simons RWP, et al. Trial-based Cost-effectiveness Analysis of Toric Versus Monofocal Intraocular Lenses in Cataract Patients With Bilateral Corneal Astigmatism in the Netherlands. J Cataract Refract Surg. 2019;45(2):146-152. PubMed PMID: 30471848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands. AU - Simons,Rob W P, AU - Visser,Nienke, AU - van den Biggelaar,Frank J H M, AU - Nuijts,Rudy M M A, AU - Webers,Carroll A B, AU - Bauer,Noel J C, AU - Beckers,Henny J M, AU - Dirksen,Carmen D, Y1 - 2018/11/22/ PY - 2018/02/02/received PY - 2018/07/05/revised PY - 2018/09/03/accepted PY - 2018/11/26/pubmed PY - 2020/8/15/medline PY - 2018/11/26/entrez SP - 146 EP - 152 JF - Journal of cataract and refractive surgery JO - J Cataract Refract Surg VL - 45 IS - 2 N2 - PURPOSE: To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (IOL) implantation in cataract patients with bilateral corneal astigmatism. SETTING: Two ophthalmology clinics in the Netherlands. DESIGN: Prospective cost-effectiveness analysis. METHODS: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio. RESULTS: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group (€3203 [$3864]) than in the monofocal IOL group (€2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P = .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of €2500 to €20 000 per QALY. CONCLUSIONS: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered. SN - 1873-4502 UR - https://www.unboundmedicine.com/medline/citation/30471848/Trial_based_cost_effectiveness_analysis_of_toric_versus_monofocal_intraocular_lenses_in_cataract_patients_with_bilateral_corneal_astigmatism_in_the_Netherlands_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0886-3350(18)30842-3 DB - PRIME DP - Unbound Medicine ER -