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Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data.
Lee, Aaron Y; Butt, Thomas; Chew, Emily; Agron, Elvira; Clemons, Traci E; Egan, Catherine A; Lee, Cecilia S; Tufail, Adnan.
Afiliación
  • Lee AY; Department of Ophthalmology, University of Washington, Seattle, Washington, USA.
  • Butt T; Institute of Ophthalmology, University College London, London, UK.
  • Chew E; Division of Epidemiology and Clinical Research, National Institutes of Health, Bethesda, Maryland, USA.
  • Agron E; Division of Epidemiology and Clinical Applications, National Eye Institute, Bethesda, Maryland, USA.
  • Clemons TE; EMMES Corporation, Rockville, Maryland, USA.
  • Egan CA; Institute of Ophthalmology, University College London, London, UK.
  • Lee CS; Moorfields Eye Hospital, London, UK.
  • Tufail A; Department of Ophthalmology, University of Washington, Seattle, Washington, USA.
Br J Ophthalmol ; 102(4): 465-472, 2018 04.
Article en En | MEDLINE | ID: mdl-28835423
AIMS: To evaluate the cost-effectiveness of Age-Related Eye Disease Study (AREDS) 1 & 2 supplements in patients with either bilateral intermediate age-related macular degeneration, AREDS category 3, or unilateral neovascular age-related macular degeneration AMD (nAMD), AREDS category 4. METHODS: A patient-level health state transition model based on levels of visual acuity in the better-seeing eye was constructed to simulate the costs and consequences of patients taking AREDS vitamin supplements. SETTING: UK National Health Service (NHS). The model was populated with data from AREDS and real-world outcomes and resource use from a prospective multicentre national nAMD database study containing 92 976 ranibizumab treatment episodes. INTERVENTIONS: Two treatment approaches were compared: immediate intervention with AREDS supplements or no supplements. MAIN OUTCOME MEASURES: quality-adjusted life years (QALYs) and healthcare costs were accrued for each strategy, and incremental costs and QALYs were calculated for the lifetime of the patient. One-way and probabilistic sensitivity analyses were employed to test the uncertainty of the model. RESULTS: For AREDS category 3, the incremental cost-effectiveness ratio was £30 197. For AREDS category 4 compared with no intervention, AREDS supplements are more effective (10.59 vs 10.43 QALYs) and less costly (£52 074 vs 54 900) over the lifetime of the patient. CONCLUSIONS: The recommendation to publicly fund AREDS supplements to category 3 patients would depend on the healthcare system willingness to pay. In contrast, initiating AREDS supplements in AREDS category 4 patients is both cost saving and more effective than no supplement use and should therefore be considered in public health policy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Zinc / Suplementos Dietéticos / Degeneración Macular / Antioxidantes Tipo de estudio: Guideline / Health_economic_evaluation Aspecto: Patient_preference Límite: Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Br J Ophthalmol Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Zinc / Suplementos Dietéticos / Degeneración Macular / Antioxidantes Tipo de estudio: Guideline / Health_economic_evaluation Aspecto: Patient_preference Límite: Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Br J Ophthalmol Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido