Maxwell William A, Waycaster Curtis R, D'Souza Anna O, Meissner Brian L, Hileman Kendra
California Eye Institute, Fresno, California, USA.
J Cataract Refract Surg. 2008 Nov;34(11):1855-61. doi: 10.1016/j.jcrs.2008.07.024.
To demonstrate the value, from the patient's perspective, of an apodized, diffractive, presbyopia-correcting multifocal intraocular lens (MF-IOL) compared to a conventional monofocal intraocular lens (CM-IOL).
Open-label, multi-site U.S. clinical trial.
A cost-benefit analysis was conducted using cataract patients' willingness-to-pay (WTP) for spectacle independence as the measure of economic benefit. WTP was elicited from participants in a clinical trial comparing a MF-IOL and a CM-IOL. Costs borne by patients were obtained from standard reference sources. A 14-year analytical timeframe was used, and a 3% annual discount rate was applied to both costs and benefits. The outcome of interest was net benefit (difference between benefits and costs). A probabilistic sensitivity analysis was used to confirm the robustness of the economic results.
Four hundred ninety-five patients provided WTP estimates for spectacle independence (MF-IOL, n = 339; CM-IOL, n = 156). Eighty percent of all patients were willing to pay at least $5 per day to be spectacle independent. The incremental acquisition cost associated with bilateral implantation of 2 MF-IOLs was estimated at $4,000. Eighty percent in the MF-IOL group and 8% in the CM-IOL group reported post-operative spectacle independence. The net benefit was $11,670 in the MF-IOL group and $155 in the CM-IOL group. The probabilistic sensitivity analysis confirmed the robustness of the economic outcomes.
The net benefit of the MF-IOL exceeded its acquisition cost and the net benefit of the CM-IOL, demonstrating its value to select cataract patients willing to pay a premium for spectacle independence.
从患者角度出发,证明与传统单焦点人工晶状体(CM-IOL)相比,变迹衍射型老视矫正多焦点人工晶状体(MF-IOL)的价值。
美国开放标签、多中心临床试验。
进行成本效益分析,将白内障患者为摆脱眼镜依赖的支付意愿(WTP)作为经济效益的衡量指标。WTP是从比较MF-IOL和CM-IOL的临床试验参与者中得出的。患者承担的成本来自标准参考资料。采用14年的分析时间范围,并对成本和效益均应用3%的年贴现率。感兴趣的结果是净效益(效益与成本之差)。采用概率敏感性分析来确认经济结果的稳健性。
495名患者提供了摆脱眼镜依赖的WTP估计值(MF-IOL组,n = 339;CM-IOL组,n = 156)。所有患者中有80%愿意每天至少支付5美元以摆脱眼镜依赖。双侧植入2枚MF-IOL的增量购置成本估计为4000美元。MF-IOL组中有80%的患者和CM-IOL组中有8%的患者术后摆脱了眼镜依赖。MF-IOL组的净效益为11670美元,CM-IOL组为155美元。概率敏感性分析证实了经济结果的稳健性。
MF-IOL的净效益超过了其购置成本以及CM-IOL的净效益,表明其对愿意为摆脱眼镜依赖支付额外费用的特定白内障患者具有价值。