Dolders M G T, Nijkamp M D, Nuijts R M M A, van den Borne B, Hendrikse F, Ament A, Groot W
Maastricht University, Department of Health Organisation, Policy and Economics - UNS 40, PO Box 616, 6200 Maastricht, Netherlands.
Br J Ophthalmol. 2004 Sep;88(9):1163-8. doi: 10.1136/bjo.2003.035527.
To analyse the cost effectiveness of foldable monofocal intraocular lenses (IOLs) compared to foldable multifocal IOLs in cataract surgery alongside a prospective, multicentre randomised clinical trial (RCT).
Patients underwent cataract surgery with bilateral monofocal (n = 97) or multifocal (n = 93) IOL implantation. Cost data and patient preferences, using the visual analogue scale (VAS), the time trade-off (TTO), and the standard gamble (SG) technique were obtained preoperatively and postoperatively by structured interviews. The incremental costs (multifocal minus monofocal), mean costs per patient, and differences in preferences were computed.
Mean costs for glasses per patient in the monofocal group were 41.67 and in the multifocal group 149.58. The difference in costs between the multifocal and monofocal group was -92.09 and was statistically significant (p = 0.008). No significant differences were found in total costs or in effectiveness between the monofocal and multifocal IOL group.
The cost effectiveness of multifocal IOLs is reduced to a cost minimisation analysis, because of the inability to demonstrate significant differences in effects. The use of multifocal IOLs in cataract surgery resulted in a significant reduction in costs for patient's postoperative spectacles.
在一项前瞻性、多中心随机临床试验(RCT)中,分析白内障手术中可折叠单焦点人工晶状体(IOL)与可折叠多焦点IOL相比的成本效益。
患者接受双侧单焦点(n = 97)或多焦点(n = 93)IOL植入的白内障手术。术前和术后通过结构化访谈获得成本数据以及患者偏好,采用视觉模拟量表(VAS)、时间权衡(TTO)和标准博弈(SG)技术。计算增量成本(多焦点减去单焦点)、每位患者的平均成本以及偏好差异。
单焦点组每位患者眼镜的平均成本为41.67,多焦点组为149.58。多焦点组和单焦点组之间的成本差异为-92.09,具有统计学意义(p = 0.008)。单焦点和多焦点IOL组在总成本或有效性方面未发现显著差异。
由于无法证明多焦点IOL在效果上有显著差异,其成本效益降低为成本最小化分析。白内障手术中使用多焦点IOL可显著降低患者术后眼镜的成本。