II 型波士顿角膜假体的成本效益。
Cost effectiveness of the type II Boston keratoprosthesis.
机构信息
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
出版信息
Eye (Lond). 2011 Mar;25(3):342-9. doi: 10.1038/eye.2010.197. Epub 2010 Dec 24.
PURPOSE
Despite demonstrated cost effectiveness, not all corneal disorders are amenable to type I Boston keratoprosthesis (KPro) implantation. This includes patients with autoimmune diseases, such as Stevens-Johnson syndrome/toxic epidermal necrolysis. Type II KPro is implanted through the eyelids in severe dry eye and cicatricial diseases, and its cost effectiveness was sought.
PATIENTS AND METHODS
In a retrospective chart review, 29 patients who underwent type II KPro surgery at the Massachusetts Eye and Ear Infirmary between the years 2000 and 2009 were identified. A total of 11 patients had 5-year follow-up data. Average cost effectiveness was determined by cost-utility analysis, comparing type II KPro surgery with no further intervention.
RESULTS
Using the current parameters, the cost utility of KPro from third-party insurer (Medicare) perspective was 63,196 $/quality-adjusted life year .
CONCLUSION
Efforts to refer those less likely to benefit from traditional corneal transplantation or type I KPro, for type II KPro surgery, may decrease both patient and societal costs.
目的
尽管已证实具有成本效益，但并非所有角膜疾病都适合进行 I 型波士顿角膜（KPro）植入。这包括患有自身免疫性疾病（如 Stevens-Johnson 综合征/中毒性表皮坏死松解症）的患者。II 型 KPro 通过眼睑植入严重干眼症和瘢痕性疾病，本研究旨在探讨其成本效益。
患者和方法
通过回顾性图表审查，在 2000 年至 2009 年间，在马萨诸塞州眼耳医院接受 II 型 KPro 手术的 29 名患者被确定。共有 11 名患者有 5 年的随访数据。通过成本效用分析，将 II 型 KPro 手术与无进一步干预进行比较，确定平均成本效益。
结果
使用当前参数，从第三方保险公司（医疗保险）的角度来看，KPro 的成本效用为 63,196 美元/质量调整生命年。
结论
努力将那些不太可能从传统角膜移植或 I 型 KPro 中受益的患者转介进行 II 型 KPro 手术，可能会降低患者和社会的成本。
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