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Cost-Effectiveness Analysis of Multifocal Intraocular Lenses Compared to Monofocal Intraocular Lenses in Cataract Surgery
- Source :
- American journal of ophthalmology. 208
- Publication Year :
- 2018
-
Abstract
- Purpose To determine the cost-effectiveness of multifocal intraocular lenses (IOLs) compared to that of monofocal IOLs from a societal and health care sector perspective. Design Cost-effectiveness analysis. Methods A Markov model was constructed that simulated patients who received either multifocal or monofocal IOLs during cataract surgery. Postoperatively, patients could experience spectacle dependence, glare, and haloes. Cost-effectiveness was determined by measuring the incremental cost-effectiveness ratio (ICER) as the incremental cost in dollars per quality-adjusted life year (QALY) gained. Treatments with an ICER below the standard willingness-to-pay (WTP) threshold of $50,000/QALY were considered cost effective. One-way sensitivity analyses and probabilistic sensitivity analyses were used to evaluate model sensitivity to cost, utilities, and other model inputs. Results Multifocal IOLs were associated with a 0.71 QALY increase at an increased cost of $3,415 compared with monofocal IOLs, leading to an ICER of $4,805/QALY from the societal and health care sector perspectives. The cost-effectiveness model was most sensitive to patient age, probability of spectacle dependence with multifocal IOLs and monofocal IOLs, and the disutility of glasses. Probabilistic sensitivity analysis found multifocal IOLs to be the cost-effective option compared with monofocal IOLs 99.9% of the time at a WTP threshold of $50,000/QALY. Conclusions From a societal and health care perspective, multifocal IOLs would be considered a cost-effective strategy compared to monofocal IOLs for patients who desire a higher chance to be spectacle-free. However, more studies need to be conducted to further evaluate the efficacy of multifocal IOLs.
- Subjects :
- Male
genetic structures
medicine.medical_treatment
Cost-Benefit Analysis
Cataract Extraction
03 medical and health sciences
0302 clinical medicine
Lens Implantation, Intraocular
Patient age
Surveys and Questionnaires
medicine
Humans
Sensitivity analyses
health care economics and organizations
030304 developmental biology
Aged
Aged, 80 and over
Lenses, Intraocular
0303 health sciences
business.industry
Cost-effectiveness analysis
Multifocal intraocular lens
Cataract surgery
Middle Aged
Patient Acceptance of Health Care
Multifocal Intraocular Lenses
eye diseases
Markov Chains
Quality-adjusted life year
Ophthalmology
Intraocular lenses
030221 ophthalmology & optometry
Optometry
Multifocal IOLs
Female
sense organs
Quality-Adjusted Life Years
business
Subjects
Details
- ISSN :
- 18791891
- Volume :
- 208
- Database :
- OpenAIRE
- Journal :
- American journal of ophthalmology
- Accession number :
- edsair.doi.dedup.....224e5472d6b1da4b241746bc84ec6d75