Cost-effectiveness of retinal detachment repair

Jonathan S. Chang, William E Smiddy

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To evaluate costs and treatment benefits of rhegmatogenous retinal detachment (RD) repair. Design A Markov model of cost-effectiveness and utility. Participants There were no participants. Methods Published clinical trials (index studies) of pneumatic retinopexy (PR), scleral buckling (SB), pars plana vitrectomy (PPV), and laser prophylaxis were used to quantitate surgical management and visual benefits. Markov analysis, with data from the Center of Medicare and Medicaid Services, was used to calculate the adjusted costs of primary repair by each modality in a hospital-based and ambulatory surgery center (ASC) setting. Main Outcome Measures Lines of visual acuity (VA) saved, cost of therapy, adjusted cost of therapy, cost per line saved, cost per line-year saved, and cost per quality-adjusted life years (QALY) saved. Results In the facility, hospital surgery setting, weighted cost for PR ranged from $3726 to $5901 depending on estimated success rate of primary repair. Weighted cost was $6770 for SB, $7940 for PPV, and $1955 for laser prophylaxis. The dollars per line saved ranged from $217 to $1346 depending on the procedure. Dollars per line-year saved ranged from $11 to $67. Dollars per QALY saved ranged from $362 to $2243. In the nonfacility, ASC surgery setting, weighted cost for PR ranged from $1961 to $3565 depending on the success rate of primary repair. The weighted costs for SB, PPV, and laser prophylaxis were $4873, $5793, and $1255, respectively. Dollars per line saved ranged from $139 to $982. The dollars per line-year saved ranged from $7 to $49, and the dollars per QALY saved ranged from $232 to $1637. Conclusions Treatment and prevention of RD are extremely cost-effective when compared with other treatment of other retinal diseases regardless of treatment modality. Retinal detachment treatment costs did not vary widely, suggesting that providers can tailor patient treatments solely on the basis of optimizing anticipated results because there were no overriding differences in financial impact.

Original languageEnglish
Pages (from-to)946-951
Number of pages6
JournalOphthalmology
Volume121
Issue number4
DOIs
StatePublished - Jan 1 2014

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Retinal Detachment
Cost-Benefit Analysis
Costs and Cost Analysis
Scleral Buckling
Temazepam
Quality-Adjusted Life Years
Vitrectomy
Lasers
Ambulatory Surgical Procedures
Therapeutics
Centers for Medicare and Medicaid Services (U.S.)
Retinal Diseases
Health Care Costs
Visual Acuity
Outcome Assessment (Health Care)
Clinical Trials

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Cost-effectiveness of retinal detachment repair. / Chang, Jonathan S.; Smiddy, William E.

In: Ophthalmology, Vol. 121, No. 4, 01.01.2014, p. 946-951.

Research output: Contribution to journalArticle

Chang, Jonathan S. ; Smiddy, William E. / Cost-effectiveness of retinal detachment repair. In: Ophthalmology. 2014 ; Vol. 121, No. 4. pp. 946-951.
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