Second-eye cataract surgery in elderly women: a cost-utility analysis conducted alongside a randomized controlled trial
Second-eye cataract surgery in elderly women: a cost-utility analysis conducted alongside a randomized controlled trial
Aim: the aim of this study was to evaluate the cost-effectiveness of second-eye cataract surgery for older women with minimal visual dysfunction in the eye to be operated on from a Health and Personal Social Services perspective, compared to waiting list controls who had already undergone first-eye cataract surgery.
Methods: a cost-utility analysis was undertaken alongside a randomized controlled trial of second-eye cataract surgery in secondary care ophthalmology clinics. A total of 239 women over 70 years old with one unoperated cataract were randomized to cataract surgery (expedited, approximately 4 weeks) or control (routine surgery, 12 months wait). Outcomes were measured in terms of quality-adjusted life years (QALYs), with health-related quality of life estimated using the EuroQol EQ-5D.
Results: the operated group had costs which were, on average, pound646 more than the control group (95% confidence interval, pound16-1276, P<0.04) and had a mean QALY gain of 0.015 (95% confidence interval, -0.039 to 0.068, P=0.59) per patient over 1 year. Therefore, the incremental cost-utility ratio was pound44,263 over the 1-year trial period. In an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pound17,299, under conservative assumptions.
Conclusions: second-eye cataract surgery is not likely to be cost-effective in the short term for those with mild visual dysfunction pre-operation. In the long term, second-eye cataract surgery appears to be cost-effective unless carer costs are included.
aged, aged, 80 and over, cataract/economics, cataract extraction/economics, cost-benefit analysis, female, health care costs, humans, models, economic, outcome assessment, health care, quality-adjusted life years
276-83
Sach, T.H.
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Foss, A.J.E
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Gregson, R.M.
fab5019b-693c-4568-8eb1-a20f5879a441
Zaman, A.
b943cf7b-900b-4ae8-a29f-c626cec3442e
Osborn, F.
95a12f89-ac22-4aa7-9787-2910599f2f77
Masud, T.
c2a91f3a-4dc9-4dc2-9102-0ff8cacdfe53
Harwood, R.H.
ecf3a13f-9699-44ec-98db-0db3f26ae1ed
February 2010
Sach, T.H.
5c09256f-ebed-4d14-853a-181f6c92d6f2
Foss, A.J.E
a7a41307-2028-4f14-8319-b27d6491fa8c
Gregson, R.M.
fab5019b-693c-4568-8eb1-a20f5879a441
Zaman, A.
b943cf7b-900b-4ae8-a29f-c626cec3442e
Osborn, F.
95a12f89-ac22-4aa7-9787-2910599f2f77
Masud, T.
c2a91f3a-4dc9-4dc2-9102-0ff8cacdfe53
Harwood, R.H.
ecf3a13f-9699-44ec-98db-0db3f26ae1ed
Sach, T.H., Foss, A.J.E, Gregson, R.M., Zaman, A., Osborn, F., Masud, T. and Harwood, R.H.
(2010)
Second-eye cataract surgery in elderly women: a cost-utility analysis conducted alongside a randomized controlled trial.
Eye, 24 (2), .
(doi:10.1038/eye.2009.112).
Abstract
Aim: the aim of this study was to evaluate the cost-effectiveness of second-eye cataract surgery for older women with minimal visual dysfunction in the eye to be operated on from a Health and Personal Social Services perspective, compared to waiting list controls who had already undergone first-eye cataract surgery.
Methods: a cost-utility analysis was undertaken alongside a randomized controlled trial of second-eye cataract surgery in secondary care ophthalmology clinics. A total of 239 women over 70 years old with one unoperated cataract were randomized to cataract surgery (expedited, approximately 4 weeks) or control (routine surgery, 12 months wait). Outcomes were measured in terms of quality-adjusted life years (QALYs), with health-related quality of life estimated using the EuroQol EQ-5D.
Results: the operated group had costs which were, on average, pound646 more than the control group (95% confidence interval, pound16-1276, P<0.04) and had a mean QALY gain of 0.015 (95% confidence interval, -0.039 to 0.068, P=0.59) per patient over 1 year. Therefore, the incremental cost-utility ratio was pound44,263 over the 1-year trial period. In an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pound17,299, under conservative assumptions.
Conclusions: second-eye cataract surgery is not likely to be cost-effective in the short term for those with mild visual dysfunction pre-operation. In the long term, second-eye cataract surgery appears to be cost-effective unless carer costs are included.
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More information
Accepted/In Press date: 16 April 2009
e-pub ahead of print date: 15 May 2009
Published date: February 2010
Keywords:
aged, aged, 80 and over, cataract/economics, cataract extraction/economics, cost-benefit analysis, female, health care costs, humans, models, economic, outcome assessment, health care, quality-adjusted life years
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Local EPrints ID: 478172
URI: http://eprints.soton.ac.uk/id/eprint/478172
ISSN: 0950-222X
PURE UUID: 74b29ff3-8013-49b1-916b-8ef4f6514084
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Date deposited: 23 Jun 2023 17:00
Last modified: 17 Mar 2024 04:19
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Contributors
Author:
T.H. Sach
Author:
A.J.E Foss
Author:
R.M. Gregson
Author:
A. Zaman
Author:
F. Osborn
Author:
T. Masud
Author:
R.H. Harwood
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