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Comparing the long-term impact on health care resources utilization and costs due to various single-piece acrylic monofocal intraocular lens implantation during cataract surgery: a cost-consequence analysis for the United Kingdom, Italy, and Denmark

Authors Dhariwal M, Bouchet C, Jawla S

Received 13 October 2018

Accepted for publication 13 December 2018

Published 14 January 2019 Volume 2019:13 Pages 169—176

DOI https://doi.org/10.2147/OPTH.S190754

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jie Zhang

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Mukesh Dhariwal,1 Christine Bouchet,2 Shantanu Jawla3

1Global Health Economics & Outcomes Research, Alcon Laboratories, Inc., Fort Worth, TX, USA; 2Global Patient Access, Novartis Pharma AG, Basel, Switzerland; 3Patient Access Services, Novartis Healthcare Private Limited, Hyderabad, India

Purpose: The objective of this study was to estimate the cost impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy and its complications due to single-piece acrylic monofocal intraocular lenses (IOLs) in the healthcare setting of United Kingdom, Italy, and Denmark.
Materials and methods: A hypothetical cost-consequence model was developed to estimate economic burden of Nd:YAG laser capsulotomy due to different single-piece acrylic monofocal IOLs. Cumulative incidence of Nd:YAG laser capsulotomy at 3 years after cataract surgery with five single-piece monofocal acrylic IOLs was sourced from retrospective data analysis of electronic medical records of cataract patients in the United Kingdom. Risk probability of post-Nd:YAG laser complications, ie, retinal detachment, glaucoma, and cystoid macular edema at 3 years was derived using published literature. Unit costs were taken from publicly available sources with all costs converted to euro (€). Number of cataract procedures per year for each country was sourced from Eurostat statistics.
Results: For the estimated cataract procedures carried out nationally every year, single-piece monofocal hydrophobic AcrySof IOL was associated with substantially lower cases of Nd:YAG laser capsulotomy procedures and subsequent complications in 3 years after cataract surgery when compared to other single-piece monofocal acrylic IOLs. The total cost savings with the use of AcrySof over other IOLs in countries assessed ranged from €0.5 to €4.7 million (vs AMO Tecnis) and €2.1 to €17.9 million (vs Rayner C-/Super-flex).
Conclusion: Incidence of Nd:YAG capsulotomy due to the choice of IOL could significantly affect healthcare budgets in the post-cataract surgery period. Our analysis indicates that single-piece monofocal AcrySof IOLs is the most cost-saving treatment option for health care systems when compared to other acrylic single-piece IOLs.

Keywords: AcrySof, cost, Nd:YAG capsulotomy, cataract, PCO, IOL

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