Trial‐based cost‐effectiveness analysis of ultrathin Descemet stripping automated endothelial keratoplasty (UT‐DSAEK) versus DSAEK

Autor: Allegonda Van der Lelij, Robert H.J. Wijdh, Mor M. Dickman, Frank J.H.M. van den Biggelaar, Jeroen van Rooij, Rob W.P. Simons, Rudy M.M.A. Nuijts, Pieter Jan Kruit, Carmen D. Dirksen, Lies Remeijer
Přispěvatelé: MUMC+: MA UECM AIOS (9), MUMC+: MA UECM Oogartsen MUMC (9), Promovendi MHN, RS: MHeNs - R3 - Neuroscience, MUMC+: KIO Kemta (9), Health Services Research, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: *AB Refractie Chirurgie Oogheelkunde (9), Oogheelkunde
Rok vydání: 2019
Předmět:
Male
ultrathin Descemet stripping automated endothelial keratoplasty
PENETRATING KERATOPLASTY
medicine.medical_specialty
POSTERIOR LAMELLAR KERATOPLASTY
Visual acuity
Composite score
Cost effectiveness
Cost-Benefit Analysis
quality‐adjusted life years
Visual Acuity
costs
Fuchs' endothelial dystrophy
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Ophthalmology
medicine
Humans
quality-adjusted life years
cost-effectiveness
Aged
Netherlands
Retrospective Studies
OUTCOMES
business.industry
Original Articles
cost‐effectiveness
Health Care Costs
General Medicine
Cost-effectiveness analysis
Descemet stripping automated endothelial keratoplasty
Quality-adjusted life year
corneal transplantation
Fuchs’ endothelial dystrophy
030221 ophthalmology & optometry
Original Article
Female
medicine.symptom
business
Descemet Stripping Endothelial Keratoplasty
030217 neurology & neurosurgery
Health Utilities Index
Zdroj: Acta Ophthalmologica
Acta ophthalmologica, 97(8), 756-763. Wiley
Acta Ophthalmologica, 97(8), 756-763. Wiley
Acta Ophthalmologica, 97(8), 756. Wiley-Blackwell
ISSN: 1755-3768
1755-375X
Popis: Purpose To evaluate the cost-effectiveness of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus standard DSAEK. Methods A cost-effectiveness analysis using data from a multicentre randomized clinical trial was performed. The time horizon was 12 months postoperatively. Sixty-four eyes of 64 patients with Fuchs' endothelial dystrophy were included and randomized to UT-DSAEK (n = 33) or DSAEK (n = 31). Relevant resources from healthcare and societal perspectives were included in the cost analysis. Quality-adjusted life years (QALYs) were determined using the Health Utilities Index Mark 3 questionnaire. The main outcome was the incremental cost-effectiveness ratio (ICER; incremental societal costs per QALY). Results Societal costs were euro9431 (US$11 586) for UT-DSAEK and euro9110 (US$11 192) for DSAEK. Quality-adjusted life years (QALYs) were 0.74 in both groups. The ICER indicated inferiority of UT-DSAEK. The cost-effectiveness probability ranged from 37% to 42%, assuming the maximum acceptable ICER ranged from euro2500-euro80 000 (US$3071-US$98 280) per QALY. Additional analyses were performed omitting one UT-DSAEK patient who required a regraft [ICER euro9057 (US$11 127) per QALY, cost-effectiveness probability: 44-62%] and correcting QALYs for an imbalance in baseline utilities [ICER euro23 827 (US$29 271) per QALY, cost-effectiveness probability: 36-59%]. Furthermore, the ICER was euro2101 (US$2581) per patient with clinical improvement in best spectacle-corrected visual acuity (>= 0.2 logMAR) and euro3274 (US$4022) per patient with clinical improvement in National Eye Institute Visual Functioning Questionnaire-25 composite score (>= 10 points). Conclusion The base case analysis favoured DSAEK, since costs of UT-DSAEK were higher while QALYs were comparable. However, additional analyses revealed no preference for UT-DSAEK or DSAEK. Further cost-effectiveness studies are required to reduce uncertainty.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje