Economic evaluation of prevention of cystoid macular edema after cataract surgery in diabetic patients: ESCRS PREMED study report 6
| Autor: | Bjorn Winkens, Rob W. P. Simons, Rudy M.M.A. Nuijts, Alexander H F Rulo, Maurits V Joosse, Laura H.P. Wielders, Carmen D. Dirksen, Marie-José Tassignon, Jan S. A. G. Schouten, Frank J.H.M. van den Biggelaar, Claudette A Veldhuizen, Willem R O Goslings, Ype Henry |
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| Přispěvatelé: | MUMC+: MA AIOS Oogheelkunde (9), RS: MHeNs - R3 - Neuroscience, Oogheelkunde, MUMC+: AB Refractie Chirurgie Oogheelkunde (9), MUMC+: MA Oogheelkunde (9), FHML Methodologie & Statistiek, RS: CAPHRI - R6 - Promoting Health & Personalised Care, MUMC+: KIO Kemta (9), Health Services Research, RS: CAPHRI - R2 - Creating Value-Based Health Care |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Triamcinolone acetonide Bevacizumab Cost-Benefit Analysis medicine.medical_treatment Visual Acuity After cataract Triamcinolone Acetonide Cataract Macular Edema law.invention Randomized controlled trial law Diabetes Mellitus Humans Medicine Prospective Studies Glucocorticoids Macular edema health care economics and organizations Diabetic Retinopathy business.industry Perioperative Cataract surgery medicine.disease Sensory Systems Surgery Ophthalmology Treatment Outcome Intravitreal Injections Economic evaluation business medicine.drug |
| Zdroj: | Journal of Cataract and Refractive Surgery, 48(5), 555-563. Elsevier Science |
| ISSN: | 1873-4502 0886-3350 |
| DOI: | 10.1097/j.jcrs.0000000000000785 |
| Popis: | PURPOSE: To investigate the cost-effectiveness of prophylactic treatments against cystoid macular edema (CME) after cataract surgery in diabetic patients.SETTING: Seven 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 uncomplicated 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: Mean total healthcare costs and QALYs were: Triamcinolone € 1827 (US$ 2295) / 0.166; Bevacizumab € 2050 (US$ 2575) / 0.144; Combination € 2027 (US$ 2546) / 0.166; Control € 2041 (US$ 2564) / 0.156. Bevacizumab and control treatment were most costly and least effective. The ICER was € 321,984 (US$ 404,503) per QALY for the combination group compared to the triamcinolone group. Assuming the willingness-to-pay is € 20,000 (US$ 25,126) per QALY, the cost-effectiveness probability was 70% and 23% in the triamcinolone and combination groups, respectively. No patient that 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 triamcinolone is also cost-effective. |
| Databáze: | OpenAIRE |
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