Second-eye cataract surgery in elderly women: a cost-utility analysis conducted alongside a randomized controlled trial

Sach, T. H. ORCID: https://orcid.org/0000-0002-8098-9220, Foss, A. J. E., Gregson, R. M., Zaman, A., Osborn, F., Masud, T. and Harwood, R. H. (2010) Second-eye cataract surgery in elderly women: a cost-utility analysis conducted alongside a randomized controlled trial. Eye, 24 (2). pp. 276-283. ISSN 1476-5454

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Abstract

AimThe aim of this study was to evaluate the cost-effectiveness of second-eye cataract surgery for older women with minimal visual dysfunction in the eye to be operated on from a Health and Personal Social Services perspective, compared to waiting list controls who had already undergone first-eye cataract surgery.MethodsA cost-utility analysis was undertaken alongside a randomized controlled trial of second-eye cataract surgery in secondary care ophthalmology clinics. A total of 239 women over 70 years old with one unoperated cataract were randomized to cataract surgery (expedited, approximately 4 weeks) or control (routine surgery, 12 months wait). Outcomes were measured in terms of quality-adjusted life years (QALYs), with health-related quality of life estimated using the EuroQol EQ-5D.ResultsThe operated group had costs which were, on average, pound646 more than the control group (95% confidence interval, pound16-1276, P>0.04) and had a mean QALY gain of 0.015 (95% confidence interval, -0.039 to 0.068, P=0.59) per patient over 1 year. Therefore, the incremental cost-utility ratio was pound44 263 over the 1-year trial period. In an analysis modelling costs and benefits over patients' expected lifetime, the incremental cost per QALY was pound17 299, under conservative assumptions.ConclusionsSecond-eye cataract surgery is not likely to be cost-effective in the short term for those with mild visual dysfunction pre-operation. In the long term, second-eye cataract surgery appears to be cost-effective unless carer costs are included.

Item Type:	Article
Faculty \ School:	Faculty of Science > School of Pharmacy (former - to 2024)
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:11
Last Modified:	24 Sep 2024 09:15
URI:	https://ueaeprints.uea.ac.uk/id/eprint/14270
DOI:	10.1038/eye.2009.112

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