Incremental cost effectiveness of laser photocoagulation for subfoveal choroidal neovascularization.

Abstract

OBJECTIVE:

To perform a patient preference-based, incremental cost-effectiveness analysis for laser treatment of subfoveal choroidal neovascularization.

DESIGN:

Computer-based econometric modeling.

METHODS:

The cost effectiveness of laser photocoagulation therapy was compared with the natural course of subfoveal choroidal neovascularization. The model applied long-term visual data from previous clinical trials, utility analysis (which reflects patient perceptions of quality of life associated with a health state), decision analysis with Markov modeling, and the economic principles of present value analysis with discounting to account for the time value of money.

DATABASE:

Data from patients eligible for treatment of subfoveal choroidal neovascularization obtained by researchers in the Macular Photocoagulation Study were used for the analysis.

INTERVENTION:

Modeled laser therapy for subfoveal choroidal neovasacularization in patients with age-related macular degeneration.

MAIN OUTCOME MEASURE:

Cost per quality-adjusted life-year ($/QALY gained) associated with laser therapy.

RESULTS:

Laser photocoagulation therapy for subfoveal choroidal neovascularization, as compared with no treatment, resulted in a mean gain of 0.257 QALYs per treated patient. Using a yearly discount rate of 3% to account for the time value of money and inflation, the resultant $/QALY gained was $5629. Sensitivity analysis used in the cost-effectiveness analysis resulted in a $/QALY gained of $4974 with no gained discount rate and $11,633 with a yearly discount rate of 10%.

CONCLUSIONS:

The incremental expense of laser therapy for the treatment of subfoveal choroidal neovascularization appears to be highly cost effective. The result, which takes into account patient preference-based utility data, compares quite favorably with other interventional therapies across different medical specialties.

• Authors: G C Brown, M M Brown, S Sharma, H Brown, W Tasman
• Journal: Ophthalmology (Ophthalmology) Vol. 107 Issue 7 Pg. 1374-80 (Jul 2000) ISSN: 0161-6420 [Print] United States
• PMID: 10889115 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Choroidal Neovascularization (economics, surgery)
• Cost-Benefit Analysis
• Decision Support Techniques
• Fovea Centralis
• Health Status
• Humans
• Laser Coagulation (economics)
• Markov Chains
• Models, Econometric
• Quality of Life
• Visual Acuity