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Cost Utility for Penetrating Keratoplasty in Patients with Poor Binocular Vision

Hirneiß, Christoph and Neubauer, A. S. and Niedermeier, Andreas and Messmer, E. M. and Ulbig, M. and Kampik, A. (2006) Cost Utility for Penetrating Keratoplasty in Patients with Poor Binocular Vision. Ophthalmology, 113 (12), pp. 2176-2180. Elsevier Science Inc.. DOI: 10.1016/j.ophtha.2006.05.060. ISSN 0161-6420.

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Abstract

PURPOSE: Cost-utility and cost-effectiveness analyses are of increasing importance to clinicians and health policy experts. This study determines the costs in Germany and other countries in relation to gain of utility for patients with bilateral poor vision owing to corneal disease undergoing penetrating keratoplasty (PK) in 1 eye. DESIGN: A cost-utility analysis was performed using retrospective clinical data and high-level evidence-based data. PARTICIPANTS: Sixty patients (mean age, 46.3 years) with bilateral poor vision who underwent PK for corneal disease. METHODS: Visual acuity and utility values were obtained before and 1 year after PK and after suture removal. A 10-year graft survival rate of 80% was assumed. Expenses included costs for the corneal transplant and surgery, medication, and optical rehabilitation. A discount rate of 5% was applied for costs and quality-adjusted life years (QALYs). Cost-utility analysis encompassed a 10-year period after surgery. MAIN OUTCOME MEASURES: The number of QALYs was calculated for the study group undergoing PK. This was divided into the cost of the procedure to get the number of euros spent per QALY gained. RESULTS: Median binocular preoperative visual acuity was -log mean angle of resolution (-logMAR) 0.91+/-0.53 (Snellen equivalent 20/160) yielding a utility value of 0.67. After suture removal and optical rehabilitation, binocular visual acuity increased to median -logMAR 0.36+/-0.36 (20/46) with a utility value of 0.79. Over the 10 years after surgery and considering graft survival and discounting, a cost utility of 9551 euros per QALY was gained (equivalent to US11,557 dollars). One-way sensitivity analysis yielded a range from 7706 euros to 12874 euros per QALY, highlighting the robustness of the model. CONCLUSIONS: Although an expensive procedure, PK is cost effective in patients with bilateral poor vision.

Document Type:Article
Title:Cost Utility for Penetrating Keratoplasty in Patients with Poor Binocular Vision
Authors:
AuthorsInstitution or Email of Authors
Hirneiß, ChristophUniversität München
Neubauer, A. S.Universität München
Niedermeier, AndreasUNSPECIFIED
Messmer, E. M.Universität München
Ulbig, M.Universität München
Kampik, A.Universität München
Date:December 2006
Journal or Publication Title:Ophthalmology
Refereed publication:Yes
In ISI Web of Science:Yes
Volume:113
DOI:10.1016/j.ophtha.2006.05.060
Page Range:pp. 2176-2180
Editors:
EditorsEmail
Schachat, Andrew P.UNSPECIFIED
Publisher:Elsevier Science Inc.
ISSN:0161-6420
Status:Published
Keywords:Augenheilkunde, Kosten-Nutzen-Analyse
HGF - Research field:other
HGF - Program:other
HGF - Program Themes:other
DLR - Research area:no assignement
DLR - Program:no assignment
DLR - Research theme (Project):other
Location: Oberpfaffenhofen
Institutes and Institutions:Remote Sensing Technology Institute > Image Science
Deposited By: Dr.rer.nat. Andreas Niedermeier
Deposited On:30 Aug 2007
Last Modified:27 Apr 2009 14:19

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