Purpose: To perform a cost-utility analysis and comparison between pneumatic retinopexy (PR) and pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) repair. Design: A cost-utility analysis using decision analysis. Participants: There were no participants. Methods: A decision analysis model was constructed based on results from the Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial to calculate the costs, lifetime usefulness, and lifetime cost per quality-adjusted life year (QALY) for the treatment of RRD with PR or PPV. Data from the Centers for Medicare and Medicaid Services were used to calculate the associated adjusted costs in facility and nonfacility practice settings. Main Outcome Measures: Cost of intervention, utility gain over natural history, QALY gained, and cost per QALY. Results: The total imputed costs (all in 2019 United States dollars) for primary repair of RRD in facility and nonfacility settings were $4451 and $2456, respectively, in the PR group and $7108 and $4514, respectively, in the PPV group. The estimated lifetime QALYs gained were 5.9 and 5.4 in the PR and PPV groups, respectively. The cost per QALY for facility and nonfacility settings was $751 and $414, respectively, in the PR group and $1312 and $833, respectively, in the PPV group. Conclusions: Cost-utility analysis of both PR and PPV demonstrated excellent results for both methods for RRD repair, with the metrics for PR somewhat more favorable independent of the practice settings (facility or nonfacility based).
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