Abstract | PURPOSE: To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). METHODS: A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. RESULTS: CONCLUSIONS: The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds.
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Authors | Gary C Brown, Melissa M Brown, Heidi C Brown, Sylvia Kindermann, Sanjay Sharma |
Journal | Transactions of the American Ophthalmological Society
(Trans Am Ophthalmol Soc)
Vol. 105
Pg. 160-9; discussion 169-71
( 2007)
ISSN: 1545-6110 [Electronic] United States |
PMID | 18427606
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Choroidal Neovascularization
(economics, therapy)
- Cost-Benefit Analysis
- Costs and Cost Analysis
- Drug Therapy
(economics)
- Health Status
- Humans
- Macular Degeneration
(economics, therapy)
- Philadelphia
- Quality of Life
- Treatment Outcome
- Visual Acuity
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