Citation

Sach TH, Foss A, Gregson R, Zaman A, Osborn F, Masud T, Harwood RH. Br. J. Ophthalmol. 2007; 91(12): 1675-1679.

Affiliation

University of Nottingham, United Kingdom.

Copyright

(Copyright © 2007, BMJ Publishing Group)

DOI

10.1136/bjo.2007.118687

PMID

17585002

PMCID

PMC2095519

Abstract

AIM: To evaluate the cost-effectiveness of first-eye cataract surgery compared to no surgery from a Health Service and Personal Social Services perspective. METHODS: An economic evaluation undertaken alongside a randomised controlled trial of first-eye cataract surgery in secondary care ophthalmology clinics. 306 women over 70 years old with bilateral cataracts were randomised to cataract surgery (expedited, approximately 4 weeks) or control (routine, 12 months wait). 75% of participants had baseline acuity of 6/12 or better. Outcomes included falls and the EuroQol EQ-5D. RESULTS: The operated group cost a mean pound2,004 (bootstrapped) more than the control group over one year (95% confidence interval pound1,363 to pound2,833, p<0.001), but experienced on average 0.456 fewer falls, an incremental cost per fall prevented of pound4,390. The bootstrapped mean gain in Quality Adjusted Life Years (QALYs) per patient was 0.056 (95% confidence interval 0.006 to 0.108, p<0.001). The incremental cost utility ratio was pound35,704, above the currently accepted UK threshold level of willingness to pay per QALY of pound30,000. However, in an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pound13,172, under conservative assumptions. CONCLUSIONS: First-eye cataract surgery, whilst cost-ineffective over the trial period, was probably cost-effective over participants' remaining lifetime.

Language: en