Healthcare costs, buyer alert

To assess the direct medical cost perspective versus the societal cost perspective associated with a vitreoretinal intervention.

Most insurers, physicians, hospital administrators, legislators and the general public refer to direct medical costs when assessing the costs associated with healthcare interventions. The direct medical cost perspective, which is the same as the third-party insurer cost perspective, includes the costs an insurer might be expected to pay, including those for physicians, hospitals, drugs, durable goods, skilled nursing facilities and others. The societal cost perspective includes direct medical costs; direct nonmedical costs (caregiver, transportation, residence); and indirect medical costs (employment and salary). When assessing the costs associated with a healthcare intervention, the societal cost perspective generally yields a greater financial return-on-investment (ROI) to society and to the gross domestic product than does the utilization of direct medical costs alone. Consequently, the use of societal costs in cost-utility analysis typically results in more cost-effective interventions than when direct medical costs alone are employed.

A societal cost perspective is more likely than the third-party insurer cost perspective to demonstrate a greater financial ROI to society.