Economic Appraisal of the Boston Ocular Surface Prosthesis

Purpose To perform an economic appraisal of the Boston Ocular Surface Prosthesis in patients with corneal ectasia, irregular astigmatism, or ocular surface disease. Design Cost, incremental cost-effectiveness, and benefit-cost analyses in a prospective observational study. Methods The effects of thi...

Full description

Saved in:
Bibliographic Details
Published in:American journal of ophthalmology 2009-12, Vol.148 (6), p.860-868.e2
Main Authors: Shepard, Donald S, Razavi, Moaven, Stason, William B, Jacobs, Deborah S, Suaya, Jose A, Cohen, Mark, Rosenthal, Perry
Format: Article
Language:English
Subjects:
Adult
Astigmatism - economics
Astigmatism - rehabilitation
Biological and medical sciences
Confidence intervals
Conjunctival Diseases
Contact Lenses - economics
Corneal Diseases
Cost-Benefit Analysis
Dilatation, Pathologic - economics
Dilatation, Pathologic - rehabilitation
Disease
Eye diseases
Female
Health Care Costs
Health care policy
Health Insurance Portability & Accountability Act 1996-US
Humans
Male
Medical research
Medical sciences
Miscellaneous
Ophthalmology
Prospective Studies
Prostheses
Prosthesis Fitting
Quality of Life
Quality-Adjusted Life Years
Questionnaires
Sickness Impact Profile
Studies
Surveys and Questionnaires
Vision Disorders - economics
Vision Disorders - rehabilitation
Visual Acuity
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose To perform an economic appraisal of the Boston Ocular Surface Prosthesis in patients with corneal ectasia, irregular astigmatism, or ocular surface disease. Design Cost, incremental cost-effectiveness, and benefit-cost analyses in a prospective observational study. Methods The effects of this scleral lens on visual functioning were measured in 69 patients who received the prosthesis in 2006 and were reassessed 6 months after fitting the prosthesis. Benefits, based on improvements in visual functioning, were converted to quality-adjusted life years (QALYs), and economic values were derived using results from published studies. Costs were estimated from the provider organization's 2006 operating financial statement with additions for donated resources and future scale-up. Results Mean scores on a 100-point visual functioning questionnaire (VFQ-25) improved from 57.0 to 77.8 ( P < .0001). On average, each fitted patient cost $11 841 ($6001 for clinical services and $5840 to produce the prosthesis). Patients' quality of life improved by 0.10 QALYs per year. Assuming that benefits persist for an average of 5 years, the lifetime gain was 0.48 QALYs; the average cost-effectiveness of the prosthesis was $24 900 per QALY (95% confidence interval $19 100 to $29 600), and the average benefit-cost ratio was 4.0 to 1. In patients with the lowest baseline scores (average VFQ score 38.6), results were even more favorable: cost-effectiveness $17100 per QALY and benefit-cost ratio 5.6 to 1. Conclusions The Boston Ocular Surface Prosthesis is cost-effective and cost beneficial in patients with severely compromised visual function attributable to ectasia, irregular astigmatism, or ocular surface disease.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2009.07.012