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Published on: December 1, 2023
Cost-utility of routine cataract surgery
Pirjo Räsänen1, Kari Krootila, Harri Sintonen
1Helsinki and Uusimaa Hospital Group, Group Administration, P,O,Box 440, 00029 HUS, Helsinki, Finland. pirjo.rasanen@stakes.fi
Health and Quality of Life Outcomes
|October 3, 2006
Summary
Routine cataract surgery offers minimal quality-of-life gains, particularly for those with both eyes operated. The cost-effectiveness, measured in cost per quality-adjusted life year (QALY), is higher than anticipated, with significant uncertainty.
Area of Science:
- Ophthalmology
- Health Economics
Background:
- Evidence on the cost-utility of routine cataract surgery in real-world settings is crucial for rational health care spending decisions.
- This study aimed to evaluate the cost-utility of routine cataract surgery.
Purpose of the Study:
- To assess the cost-utility of routine cataract surgery in a real-world clinical setting.
- To determine the impact of cataract surgery on health-related quality of life (HRQoL).
Main Methods:
- Prospective evaluation of 219 patients undergoing cataract surgery, assessing HRQoL using the 15D questionnaire before and six months post-operation.
- Calculation of direct hospital costs and performance of cost-utility analysis from a secondary care provider's perspective.
- Extrapolation of surgical benefits to patients' remaining statistical life expectancy.
Main Results:
- Overall mean utility scores showed an insignificant increase from 0.82 to 0.83.
- Significant HRQoL improvement was observed only in the 'seeing' dimension and in patients with severe preoperative vision problems.
- Patients undergoing bilateral surgery demonstrated a statistically significant HRQoL improvement (p < 0.001).
- Cost per QALY was €5128 for bilateral surgery and €8212 for unilateral surgery.
- Deterioration in HRQoL was noted in patients with prior eye surgery, precluding cost-per-QALY calculation.
Conclusions:
- Routine cataract surgery yielded modest utility gains, primarily in patients receiving bilateral procedures.
- The cost per QALY for cataract surgery was substantially higher than previously reported, with considerable uncertainty.
- Findings suggest that the cost-utility of routine cataract surgery may be less favorable than commonly assumed.
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