Immediate versus delayed sequential bilateral cataract surgery in children: a cost-effectiveness analysis

2020 ◽  
pp. bjophthalmol-2020-316507
Author(s):  
Alexandra Cernat ◽  
Margaret Jamieson ◽  
RuthAnne Kavelaars ◽  
Sina Khalili ◽  
Vishaal Bhambhwani ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health System ◽  
Cataract Surgery ◽  
Cost Effectiveness Analysis ◽  
Visual Axis ◽  
Visual Rehabilitation ◽  
System Perspective ◽  
Bilateral Cataract ◽  
Paediatric Hospital ◽  
Effectiveness Analysis

Background/aimsChildren with bilateral cataracts may undergo immediate sequential bilateral cataract surgery (ISBCS), which involves surgery on both eyes during the same general anaesthesia, or delayed sequential bilateral cataract surgery (DSBCS), which involves operating on each eye on separate days and requires a second anaesthesia. ISBCS is viewed with caution because of the risk of bilateral endophthalmitis. Proponents of ISBCS emphasise that the incidence of serious complications is low and is outweighed by benefits such as avoidance of multiple anaesthesia, faster visual rehabilitation and potential for decreased costs. However, there is a paucity of literature regarding the cost-effectiveness of ISBCS in children. We conducted a cost-effectiveness analysis to determine whether ISBCS is more cost-effective than DSBCS from the societal and health system perspectives in Ontario, Canada, which has a universal, single-payer system.MethodsA retrospective analysis of children who underwent ISBCS or DSBCS at a tertiary referral paediatric hospital was conducted. A decision tree was constructed using TreeAge Pro 2018 software. Clear visual axis was the measure of effectiveness. A time horizon of 8 weeks postoperatively was adopted. Both direct and indirect costs were included.ResultsFifty-three children were included, 37 in the ISBCS group and 16 in the DSBCS group. ISBCS and DSBCS were equally effective. ISBCS resulted in cost-savings of $3,776 (95% CI:−$4,641 to $12,578) CAD, per patient, from the societal perspective and $2,200 (95% CI:−$5,615 to $10,373) CAD per patient from the health system perspective.ConclusionISBCS was less costly than DSBCS from both societal and health system perspectives while being equally effective.

scholarly journals Pharmacoeconomic Analysis of Using Different Types of Monofocal Intraocular Lenses for Cataract Surgery in Russia

2019 ◽  
Vol 16 (1) ◽  
pp. 131-141
Author(s):  
I. S. Krysanov ◽  
V. S. Krysanova ◽  
V. Yu. Ermakova
Keyword(s):  
Cost Effectiveness ◽  
Cataract Surgery ◽  
Medical Costs ◽  
Cost Effectiveness Analysis ◽  
Intraocular Lenses ◽  
System Perspective ◽  
Direct Medical Costs ◽  
Effectiveness Analysis ◽  
Different Types ◽  
Monofocal Iol

Purpose: To perform cost-effectiveness analysis of using different types of monofocal intraocular lenses (IOL) for cataract surgery in adults in Russian Federation. Materials and methods. MS Excel based model of medical care patients with cataract has been developed for 1 patient undergoing surgery treatment. “cost-effectiveness” and “budget impact” analyses (BIA) were used to measure the costs associated with cataract treatment with different types of monofocal IOLs for the state budget. Direct medical costs included IOLs cost, treatment of PCO with neodymium-doped uttrium aluminium garnet laser capsulotomy (Nd:YAG), side effects treatment associated with Nd:YAG and were calculated from the Russian healthcare system perspective. Results. Cost-effectiveness analysis among monofocal IOLs demonstrated that the lowest costs for 1 case of successful cataract surgery followed by implantation of the IOL are connected with the use of the AcrySof® Single Piece model — 4,938 rubles, the largest costs — using the Tecnis® One model — 11,753.5 rubles. The use of others hydrophobic IOLs on the AcrySof® platform demonstrated economic feasibility, analyzed models have costs for 1 effective cataract treatment -AcrySof® IQ 9,858 rubles, AcrySof® Natural 6,452 rubles. The conducted BIA has showed that direct medical costs for surgical treatment of cataracts with the implantation of monofocal IOLs from different manufacturers for 100 patients amount to 708,121 rubles. If ua monofocal IOL are used alone on an AcrySof® platform, the cost will be 691,261 rubles, the difference is in favor of monofocal IOL on an AcrySof® platform — 16,860 rubles. Conclusion. Using AcrySof® IOLs for cataract surgery in adult patients is an effective and an economically justified treatment option in Russia Federation.

scholarly journals PSS27 - A COST-EFFECTIVENESS ANALYSIS OF TWO VISUAL ACUITY CUTOFFS FOR CATARACT SURGERY IN PATIENTS WITH PSEUDOEXFOLIATION IN UNITED KINGDOM

2018 ◽  
Vol 21 ◽  
pp. S427
Author(s):  
P. Vázquez Ferreiro ◽  
C. Crespo ◽  
J. Carrera Hueso ◽  
M.A. Ramón Barrios ◽  
J.E. Poquet-Jornet
Keyword(s):  
Visual Acuity ◽  
United Kingdom ◽  
Cost Effectiveness ◽  
Cataract Surgery ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis

Cost-Effectiveness Analysis of PMMA, Silicone, or Acrylic Intra-Ocular Lenses in Cataract Surgery in Four European Countries

2005 ◽  
Vol 12 (5) ◽  
pp. 343-351 ◽  
Author(s):  
Andrew F. Smith ◽  
Antoine Lafuma ◽  
Gilles Berdeaux ◽  
Patrizia Berto ◽  
Bernd Brueggenjuergen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cataract Surgery ◽  
Cost Effectiveness Analysis ◽  
European Countries ◽  
Effectiveness Analysis

Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country

2019 ◽  
Vol 26 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Matt Boyd ◽  
Giorgi Kvizhinadze ◽  
Adeline Kho ◽  
Graham Wilson ◽  
Nick Wilson
Keyword(s):  
Cost Effectiveness ◽  
Health System ◽  
Cataract Surgery ◽  
Health Gain ◽  
Cost Effective ◽  
Falls Prevention ◽  
Age Group ◽  
System Perspective ◽  
Life Years ◽  
Incident Cases

AimTo estimate the health gain, health system costs and cost-effectiveness of cataract surgery when expedited as a falls prevention strategy (reducing the waiting time for surgery by 12 months) and as a routine procedure.MethodsAn established injurious falls model designed for the New Zealand (NZ) population (aged 65+ years) was adapted. Key parameters relating to cataracts were sourced from the literature and the NZ Ministry of Health. A health system perspective with discounting at 3% was used.ResultsExpedited cataract surgery for 1 year of incident cases was found to generate a total 240 quality-adjusted life years (QALYs) (95% uncertainty interval (UI) 161 to 360) at net health system costs of NZ$2.43 million (95% UI 2.02 to 2.82 million) over the remaining lifetimes of the surgery group. This intervention was cost-effective by widely accepted standards with an incremental cost-effectiveness ratio (ICER) of NZ$10 600 (US$7540) (95% UI NZ$6030 to NZ$15 700) per QALY gained. The level of cost-effectiveness did not vary greatly by sex, ethnicity and previous fall history, but was higher for the 65–69 age group compared with the oldest age group of 85–89 years (NZ$7000 vs NZ$14 200 per QALY gained). Comparing cataract surgery with no surgery, the ICER was even more favourable at NZ$4380 (95% UI 2410 to 7210) per QALY. Considering only the benefits for vision improvement and excluding the benefits of falls prevention, it was still favourable at NZ$9870 per QALY.ConclusionsExpedited cataract surgery appears very cost-effective. Routine cataract surgery is itself very cost-effective, and its value appears largely driven by the falls prevention benefits.

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