Cost-effectiveness of cataract surgery. Method to assess cost-effectiveness using registry data

Area of Science:

• Health Economics
• Ophthalmology
• Public Health

Background:

• Cataract surgery is a common procedure with significant impact on patient quality of life.
• Estimating the cost-effectiveness of interventions like cataract surgery is crucial for healthcare resource allocation.
• Large patient registries offer valuable data for health economic evaluations.

Purpose of the Study:

• To develop and validate a method for estimating the cost per quality-adjusted life year (QALY) gained from cataract surgery.
• To assess the correlation between visual acuity, visual disability, and health utility.
• To utilize data from large patient registries for cost-effectiveness analysis of cataract surgery.

Main Methods:

• Prospective study involving 500 patients undergoing cataract extraction in Sweden.
• Utilized EQ-5D (quality-of-life) and Catquest (disability) measures pre-surgery.
• Employed multiple regression analysis to correlate visual acuity and disability with utility and QALY gain.
• Estimated cost per QALY using Swedish Cataract Registry data with a 3% discount rate.

Main Results:

• Utility scores significantly correlated with both visual acuity and disability scores.
• These correlations remained significant even when both factors were included in regression models.
• The estimated cost per QALY gained for cataract surgery was 45,000 SEK (approximately $4,500 USD).
• Visual acuity and disability were identified as significant determinants of utility, independent of age and comorbidity.

Conclusions:

• It is feasible to estimate the cost-effectiveness of cataract surgery using readily available data in large patient registries.
• Visual acuity and disability are key factors influencing health utility and should be considered in cost-per-QALY calculations.
• This method allows for the comparison of cataract surgery's cost-effectiveness with other healthcare interventions.