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Am J Ophthalmol. 2010 Feb;149(2):221-228.e2. doi: 10.1016/j.ajo.2009.08.027. Epub 2009 Nov 24.

Cost-effectiveness of the Boston keratoprosthesis.

Author information

  • 1Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA 02114-4724, USA. jared_ament@meei.harvard.edu

Abstract

PURPOSE:

To conduct a cost-utility analysis and determine the cost-effectiveness of the Boston Keratoprosthesis (Boston Kpro).

DESIGN:

Retrospective cohort study.

METHODS:

setting: The Massachusetts Eye and Ear Infirmary corneal service. patients: Inclusion required a minimum 2-year follow-up. Patients with autoimmune diseases and chemical burns were excluded. Eighty-two patients were included with various indications for surgery. intervention: The keratoprosthesis is a collar button-shaped polymethylmethacrylate (PMMA) device consisting of 2 curved plates sandwiched around a corneal donor (allo)graft. The device is assembled intraoperatively and sutured to a patient's eye after removing the diseased cornea.

MAIN OUTCOME MEASURES:

Average cost-effectiveness of the keratoprosthesis was determined by cost-utility analysis, using expected-value calculations and time-tradeoff utilities. The comparative effectiveness, or gain in quality-adjusted life years (QALYs), was also sought. Cost-effectiveness was compared to recently published data on penetrating keratoplasty (PK).

RESULTS:

A total discounted incremental QALY gain for the Boston Kpro of 0.763 correlated with a conferred QALY gain of 20.3% for the average patient. The average cost-effectiveness of the keratoprosthesis was $16 140 per QALY.

CONCLUSIONS:

Comparable to corneal transplantation, with a cost-effectiveness between $12 000 and $16 000 per QALY, the keratoprosthesis can be considered highly cost-effective.

Copyright (c) 2010 Elsevier Inc. All rights reserved.

PMID:
19939347
[PubMed - indexed for MEDLINE]
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