Cost-Effectiveness Analysis Of Multifocal Iols Compared To Monofocal Iols In Cataract Surgery In South Korea
Published 2023 - 41st Congress of the ESCRS
Reference: PO0596 | Type: Free paper | DOI: 10.82333/f01n-m255
Authors: Won Seok Song 1 , Yeo Kyoung Won 1 , Sun-Hong Kwon 2 , Jin Hyun Nam 3 , Serim Min 2 , Tae-Young Chung 1 , Jisang Han 4 , Dong Hui Lim* 1
1Department of Ophthalmology,Samsung medical center,Seoul,Korea, Republic Of, 2Department of Pharmacy,SungKyunKwan University,Suwon,Korea, Republic Of, 3Division of big data science,Korea University Sejong campus,Sejong,Korea, Republic Of, 4Department of Ophthalmology,Kangbuk Samsung Hospital,Seoul,Korea, Republic Of
Purpose
To evaluate the cost-effectiveness of bilateral cataract surgery using multifocal intraocular lens (IOL) for patients who wish to correct presbyopia.
Setting
South Korea
Methods
To compare multifocal IOLs, a microsimulation model was designed with 10,000 virtual patients using the values of postoperative 1 year from the previous thirteen multicenter study in Korea that evaluated the rate of near vision reaching 0.5. The time horizon was one year, and the individual quality-adjusted life-year (QALY) was calculated based on utilities, assigned according to the category of near vision (good, moderate, and poor near vision) and the need for spectacle. The cost included cataract surgery and multifocal IOLs, observed from the claims data and the market data. The incremental cost-effectiveness ratio (ICER) was estimated for each multifocal IOLs. Scenario analysis was performed for each price range of multifocal IOLs.
Results
Average QALY gained was 0.945 for trifocal and EDOF IOLs, 0.934 for bifocal IOLs, and 0.820 for monofocal IOLs. The average costs were $5,786 with bifocal, $6,919 with EDOF, $7,091 with trifocal IOLs, while that of monofocal IOLs was $1,724. The ICERs for each multifocal IOLs ranged from $41,030 to $48,791. In scenario analysis, multifocal IOLs were cost-effective when the price of the multifocal IOLs less than $2000. When the price of the multifocal IOL decreased, the probability of being cost-effective increased.
Conclusions
Compared to monofocal IOL, there are improvement in near vision and patients’ quality of life with multifocal IOLs. Even though the level of current prices in multifocal IOLs are not cost-effective, it can be cost-effectiveness if those prices are about $2000 in South Korea. Therefore, policy makers can consider pay for multifocal IOLs to improve access to eye care and to reduce health care disparity if their prices get cheaper.