| Abstrakt: |
Context: Cataract surgery is the most frequent elective surgical procedure, exceeding in number the sum of the next 5 most commonly performed surgical procedures, costing 12% ($3.4 billion) of the USA Medicare budget. Although the Age Related Eye Disease Study (AREDS) has shown no nutritional efficacy in cataract risk reduction, the REA CT study, using a more sensitive endpoint, found significant reduction in cataract progression using an antioxidant cocktail of vitamins E, C, and β-carotene. Incidence data for cataract, broken down by age and sex for the entire population of the province of Ontario, Canada, were obtained from the Ontario Health Insurance Plan (OHIP). Objectives: to estimate the potential economic consequences to Ontario of the REACT antioxidant cocktail consisting of B-carotene, vitamin E and vitamin C, for reduction of risk of cataract in a cohort of all people initially aged 50–54 years in 2001. Methods: Using extrapolated values for risk reductions, potential savings were calculated as the incremental cost difference between the estimated medical costs for the untreated cohort and the same cohort if treated with the REACT cocktail. Different scenarios were explored for cost savings. Results: For the Ontario cohort of ca. 788,000,for the REACT cocktail treatment, costs were $101 million: savings of $37 million or $364per cataract operation averted were calculated. Conclusion: PLEA CT antioxidant supplementation appears to be a dominant strategy for reducing risk of cataract. Applied to the whole Canadian population, the potential medical cost savings for cataract are $1.46 billion direct costs. These values would be tenfold higher for the USA, because of the population size and currency difference. Averting the need for some cataract operations would reduce the need for scarce operating rooms: an estimate would be freeing up approximately 20 operating rooms for Canada, the equivalent to the operating rooms of several large hospitals. Optometrists could use REA CT medication to decrease the need for surgeries. Key words: Cataract, risk reduction, present value, cost savings, economic effects, vitamins E, C, and β-carotene, REACT, oxidative stress. [ABSTRACT FROM AUTHOR] |
