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Am J Ophthalmol. 2014 Jan;157(1):78-84.e2. doi: 10.1016/j.ajo.2013.08.004. Epub 2013 Sep 29.

Cost-effectiveness of osteo-odonto keratoprosthesis in Singapore.

Author information

1
Duke-NUS Graduate Medical School, Singapore, Republic of Singapore.
2
Singapore National Eye Centre, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore, Republic of Singapore.
3
Duke-NUS Graduate Medical School, Singapore, Republic of Singapore; Singapore National Eye Centre, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore, Republic of Singapore. Electronic address: Jodmehta@gmail.com.

Abstract

PURPOSE:

To determine the long-term cost-effectiveness of osteo-odonto keratoprosthesis (OOKP) relative to no treatment among patients with end-stage corneal and ocular surface diseases in Singapore.

DESIGN:

Cost-effectiveness analysis based on data from a retrospective cohort study.

METHODS:

From a health system perspective, we calculated the incremental cost-effectiveness ratio of OOKP treatment relative to no treatment over a 30-year horizon, based on data from a cohort of 23 patients who underwent OOKP surgery between 2004 and 2009 at Singapore National Eye Centre. Preoperative and postoperative vision-related quality-of-life values were estimated from patients' visual outcomes and were used to calculate the gain in quality-adjusted life years (QALYs) resulting from OOKP treatment. Unsubsidized costs for surgery, consultations, examinations, medications, follow-up visits, and treatments for complications were retrieved from patients' bills to estimate the total costs associated with OOKP treatment. Sensitivity analyses were conducted to test the robustness of the model.

RESULTS:

Over a 30-year period, OOKP treatment, compared with no treatment, improved QALYs by 3.991 among patients with end-stage corneal and ocular surface diseases at an additional cost of S$67 840 (US$55 150), resulting in an incremental cost-effectiveness ratio of S$17 000/QALY (US$13 820/QALY).

CONCLUSIONS:

Based on commonly cited cost-effectiveness benchmarks, the OOKP is a cost-effective treatment for patients with end-stage corneal and ocular surface diseases.

PMID:
24083686
DOI:
10.1016/j.ajo.2013.08.004
[Indexed for MEDLINE]

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