Economic evaluation of prevention of cystoid macular edema after cataract surgery in diabetic patients: ESCRS PREMED study report 6.
J Cataract Refract Surg
; 48(5): 555-563, 2022 05 01.
Article
em En
| MEDLINE
| ID: mdl-34417781
ABSTRACT
PURPOSE:
To investigate the cost-effectiveness of prophylactic treatments against cystoid macular edema after cataract surgery in diabetic patients.SETTING:
7 ophthalmology clinics in the Netherlands and Belgium.DESIGN:
Prospective trial-based cost-effectiveness analysis using data from a European multicenter randomized clinical trial.METHODS:
Diabetic patients (n = 163) undergoing uneventful cataract surgery were randomized to perioperative subconjunctival triamcinolone acetonide (n = 36), perioperative intravitreal bevacizumab (n = 36), combination treatment (n = 45), or no additional treatment (control group, n = 46). The cost analysis was performed from a healthcare perspective within a 12-week postoperative time horizon. The main effectiveness outcome was quality-adjusted life years (QALYs). The main cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER; cost per QALY).RESULTS:
The mean total healthcare costs and QALYs were as follows triamcinolone group 1827 (U.S. dollars [$] 2295)/0.166; bevacizumab group 2050 ($2575)/0.144; combination group 2027 ($2546)/0.166; and control group 2041 ($2564)/0.156. Bevacizumab and control treatment were most costly and least effective. The ICER was 321 984 ($404 503) per QALY for the combination group compared with that of the triamcinolone group. Assuming the willingness-to-pay as 20 000 ($25 126) per QALY, the cost-effectiveness probability was 70% and 23% in the triamcinolone and combination groups, respectively. No patient who received triamcinolone developed clinically significant macular edema (CSME). A secondary cost-effectiveness analysis based on this outcome showed a clear preference for triamcinolone.CONCLUSIONS:
In diabetic patients, subconjunctival triamcinolone was effective in preventing CSME after cataract surgery. The cost-effectiveness analysis showed that triamcinolone is also cost-effective.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Catarata
/
Edema Macular
/
Diabetes Mellitus
/
Retinopatia Diabética
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Cataract Refract Surg
Assunto da revista:
OFTALMOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article