Afficher la notice abrégée

Cost Utility and Value of Information Analysis of Femtosecond Laser-Assisted Cataract Surgery

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBENARD, Antoine
dc.contributor.authorSITTA, Remi
dc.contributor.authorBREZIN, Antoine Pierre
dc.contributor.authorCOCHENER, Beatrice
dc.contributor.authorMONNET, Dominique
dc.contributor.authorDENIS, Philippe
dc.contributor.authorPISELLA, Pierre-Jean
dc.contributor.authorHAYES, Nathalie
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorSCHWEITZER, Cedric
ORCID: 0000-0002-2162-9479
IDREF: 133631583
dc.date.accessioned2023-06-21T11:22:46Z
dc.date.available2023-06-21T11:22:46Z
dc.date.issued2023-05-18
dc.identifier.issn2168-6173 (Electronic) 2168-6165 (Print)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/182737
dc.description.abstractEnIMPORTANCE: The efficacy and safety of femtosecond laser-assisted cataract surgery is well documented. An important requirement for decision makers is the evaluation of the cost-effectiveness of femtosecond laser-assisted cataract surgery (FLACS) over a sufficiently long horizon. Evaluating the cost-effectiveness of this treatment was a preplanned secondary objective of the Economic Evaluation of Femtosecond Laser Assisted Cataract Surgery (FEMCAT) trial. OBJECTIVE: To estimate the cost utility of FLACS compared with phacoemulsification cataract surgery (PCS) on a 12-month time horizon. DESIGN, SETTING, AND PARTICIPANTS: This multicenter randomized clinical trial compared FLACS with PCS in parallel groups. All FLACS procedures were performed using the CATALYS precision system. Participants were recruited and treated in ambulatory surgery settings in 5 university-hospital centers in France. All consecutive patients eligible for a unilateral or bilateral cataract surgery 22 years or older with written informed consent were included. Data were collected from October 2013 to October 2018, and data were analyzed from January 2020 to June 2022. INTERVENTIONS: FLACS or PCS. MAIN OUTCOMES AND MEASURES: Utility was measured through the Health Utility Index questionnaire. Costs of cataract surgery were estimated by microcosting. All inpatient and outpatient costs were collected from the French National Health Data System. RESULTS: Of 870 randomized patients, 543 (62.4%) were female, and the mean (SD) age at surgery was 72.3 (8.6) years. A total of 440 patients were randomized to receive FLACS and 430 to receive PCS; the rate of bilateral surgery was 63.3% (551 of 870). The mean (SD) costs of cataract surgery were €1124.0 (€162.2; US $1235) for FLACS and €565.5 (€61.4; US $621) for PCS. The total mean (SD) cost of care at 12 months was €7085 (€6700; US $7787) in participants treated with FLACS and €6502 (€7323; US $7146) in participants treated with PCS. FLACS yielded a mean (SD) of 0.788 (0.009) quality-adjusted life-years (QALYs), and PCS yielded 0.792 (0.009) QALYs. The difference in mean costs was €545.9 (95% CI, -434.1 to 1525.8; US $600), and the difference in QALYs was -0.004 (95% CI, -0.028 to 0.021). The incremental cost-effectiveness ratio (ICER) was -€136 476 (US $150 000) per QALY. The cost-effectiveness probability of FLACS compared with PCS was 15.7% for a cost-effectiveness threshold of €30 000 (US $32 973) per QALY. At this threshold, the expected value of perfect information was €246 139 079 (US $270 530 231). CONCLUSIONS AND RELEVANCE: The ICER of FLACS compared with PCS was not within the $50 000 to $100 000 per QALY range frequently cited as cost-effective. Additional research and development on FLACS is needed to improve its effectiveness and lower its price. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01982006.
dc.language.isoENen_US
dc.title.enCost Utility and Value of Information Analysis of Femtosecond Laser-Assisted Cataract Surgery
dc.title.alternativeJAMA Ophthalmolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1001/jamaophthalmol.2023.1716en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed37200037en_US
bordeaux.journalJAMA Ophthalmologyen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamLEHA_BPHen_US
bordeaux.teamPHARES_BPHen_US
bordeaux.teamUSMRen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-04136080
hal.version1
hal.date.transferred2023-06-21T11:22:49Z
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=JAMA%20Ophthalmology&rft.date=2023-05-18&rft.eissn=2168-6173%20(Electronic)%202168-6165%20(Print)&rft.issn=2168-6173%20(Electronic)%202168-6165%20(Print)&rft.au=BENARD,%20Antoine&SITTA,%20Remi&BREZIN,%20Antoine%20Pierre&COCHENER,%20Beatrice&MONNET,%20Dominique&rft.genre=article


Fichier(s) constituant ce document

FichiersTailleFormatVue

Il n'y a pas de fichiers associés à ce document.

Ce document figure dans la(les) collection(s) suivante(s)

Afficher la notice abrégée