Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands

Rob W. P. Simons; Nienke Visser; Frank J. H. M. van den Biggelaar; Rudy M. M. A. Nuijts; Carroll A. B. Webers; Noel J. C. Bauer; Henny J. M. Beckers; Carmen D. Dirksen

doi:10.1016/j.jcrs.2018.09.019

Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands

Rob W. P. Simons^*, Nienke Visser, Frank J. H. M. van den Biggelaar, Rudy M. M. A. Nuijts, Carroll A. B. Webers, Noel J. C. Bauer, Henny J. M. Beckers, Carmen D. Dirksen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Purpose: To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (100 implantation in cataract patients with bilateral corneal astigmatism.

Setting: Two ophthalmology clinics in the Netherlands.

Design: Prospective cost-effectiveness analysis.

Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio.

Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group ((sic)3203 [$3864]) than in the monofocal IOL group ((sic)2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P = .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of (sic)2500 to (sic)20 000 per QALY.

Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered. (C) 2018 ASCRS and ESCRS

Original language	English
Pages (from-to)	146-152
Number of pages	7
Journal	Journal of Cataract and Refractive Surgery
Volume	45
Issue number	2
DOIs	https://doi.org/10.1016/j.jcrs.2018.09.019
Publication status	Published - Feb 2019

Keywords

IMPLANTATION
OUTCOMES

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Cite this

Simons, R. W. P., Visser, N., van den Biggelaar, F. J. H. M., Nuijts, R. M. M. A., Webers, C. A. B., Bauer, N. J. C., Beckers, H. J. M., & Dirksen, C. D. (2019). Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands. Journal of Cataract and Refractive Surgery, 45(2), 146-152. https://doi.org/10.1016/j.jcrs.2018.09.019

@article{5d84464f37884049aef53cfc84ed920f,

title = "Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands",

abstract = "Purpose: To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (100 implantation in cataract patients with bilateral corneal astigmatism.Setting: Two ophthalmology clinics in the Netherlands.Design: Prospective cost-effectiveness analysis.Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio.Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group ((sic)3203 [$3864]) than in the monofocal IOL group ((sic)2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P = .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of (sic)2500 to (sic)20 000 per QALY.Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered. (C) 2018 ASCRS and ESCRS",

keywords = "IMPLANTATION, OUTCOMES",

author = "Simons, {Rob W. P.} and Nienke Visser and {van den Biggelaar}, {Frank J. H. M.} and Nuijts, {Rudy M. M. A.} and Webers, {Carroll A. B.} and Bauer, {Noel J. C.} and Beckers, {Henny J. M.} and Dirksen, {Carmen D.}",

note = "Funding Information: Supported by the Ministry of Health, Welfare, and Sport and the Netherlands Organisation for Health Research and Development (grant 171001011 ). The funding organization was not involved in any part of the study design and conduct; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Funding Information: Supported by the Ministry of Health, Welfare, and Sport and the Netherlands Organisation for Health Research and Development (grant 171001011). The funding organization was not involved in any part of the study design and conduct; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2018 ASCRS and ESCRS",

year = "2019",

month = feb,

doi = "10.1016/j.jcrs.2018.09.019",

language = "English",

volume = "45",

pages = "146--152",

journal = "Journal of Cataract and Refractive Surgery",

issn = "0886-3350",

publisher = "Elsevier Science",

number = "2",

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Simons, RWP, Visser, N, van den Biggelaar, FJHM, Nuijts, RMMA , Webers, CAB , Bauer, NJC , Beckers, HJM & Dirksen, CD 2019, 'Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands', Journal of Cataract and Refractive Surgery, vol. 45, no. 2, pp. 146-152. https://doi.org/10.1016/j.jcrs.2018.09.019

Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands. / Simons, Rob W. P.; Visser, Nienke; van den Biggelaar, Frank J. H. M. et al.
In: Journal of Cataract and Refractive Surgery, Vol. 45, No. 2, 02.2019, p. 146-152.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands

AU - Simons, Rob W. P.

AU - Visser, Nienke

AU - van den Biggelaar, Frank J. H. M.

AU - Nuijts, Rudy M. M. A.

AU - Webers, Carroll A. B.

AU - Bauer, Noel J. C.

AU - Beckers, Henny J. M.

AU - Dirksen, Carmen D.

N1 - Funding Information: Supported by the Ministry of Health, Welfare, and Sport and the Netherlands Organisation for Health Research and Development (grant 171001011 ). The funding organization was not involved in any part of the study design and conduct; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Funding Information: Supported by the Ministry of Health, Welfare, and Sport and the Netherlands Organisation for Health Research and Development (grant 171001011). The funding organization was not involved in any part of the study design and conduct; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Publisher Copyright: © 2018 ASCRS and ESCRS

PY - 2019/2

Y1 - 2019/2

N2 - Purpose: To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (100 implantation in cataract patients with bilateral corneal astigmatism.Setting: Two ophthalmology clinics in the Netherlands.Design: Prospective cost-effectiveness analysis.Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio.Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group ((sic)3203 [$3864]) than in the monofocal IOL group ((sic)2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P = .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of (sic)2500 to (sic)20 000 per QALY.Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered. (C) 2018 ASCRS and ESCRS

AB - Purpose: To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (100 implantation in cataract patients with bilateral corneal astigmatism.Setting: Two ophthalmology clinics in the Netherlands.Design: Prospective cost-effectiveness analysis.Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio.Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group ((sic)3203 [$3864]) than in the monofocal IOL group ((sic)2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P = .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of (sic)2500 to (sic)20 000 per QALY.Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered. (C) 2018 ASCRS and ESCRS

KW - IMPLANTATION

KW - OUTCOMES

U2 - 10.1016/j.jcrs.2018.09.019

DO - 10.1016/j.jcrs.2018.09.019

M3 - Article

C2 - 30471848

SN - 0886-3350

VL - 45

SP - 146

EP - 152

JO - Journal of Cataract and Refractive Surgery

JF - Journal of Cataract and Refractive Surgery

IS - 2

ER -