September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Cost-utility analysis of cataract extraction by phacoemulsification versus combined phacotrabeculectomy in treating chronic angle closure glaucoma (CACG) with coexisting cataract
Author Affiliations & Notes
  • Xiaofei MAN
    Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Footnotes
    Commercial Relationships   Xiaofei MAN, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Xiaofei MAN; Cost-utility analysis of cataract extraction by phacoemulsification versus combined phacotrabeculectomy in treating chronic angle closure glaucoma (CACG) with coexisting cataract. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the 2-year cost-utility of cataract extraction by phacoemulsification versus combined phacotrabeculectomy in treating chronic angle closure glaucoma (CACG) with coexisting cataract.

Methods : CACG patients with coexisting cataract recruited into 2 randomized controlled trials comparing phacoemulsification alone versus combined phacotrabeculectomy were pooled for analysis. A decision-analytic health model was developed to determine the cost-effectiveness and cost-utility of treating CACG with two surgical therapies to lower IOP and prevent progressive visual field loss. Incremental cost-effectiveness ratios (ICER) of treating all patients with CACG were directly calculated. Sensitivity analysis was performed by varying the cost data set from three different cities or hospitals.
Main Outcome Measures:
2-year cost-utility of treating CACG in terms of cost per quality-adjusted life-years (QALY) gained.

Results : Results: In terms of cost per IOP reduction, the ICER of treating CACG with Phacoemulsification versus combined phacotrabeculectomy is -380 $/mmHg in USA; -277$/mmHg in Tongren Hospital, PRC; -25 $/mmHg in Aravind Hospital, India respectively. In terms of cost per quality-adjusted life-years (QALY) gained, the ICER of treating CACG with Phacoemulsification versus combined phacotrabeculectomy is 40044 $/QALY in USA; 23921$/QALY in Tongren Hospital, PRC; 2634 $/QALY in Aravind Hospital respectively.

Conclusions : Within 2 years, combined PhacoTbx cost less than Phacoemulsification considering the benefit of reducing IOP after surgery, but the cost-effectiveness is marginal.
Within 2-years, phacoemulsification is cost effective than combined phacotbx in treating CACG with cataracts in USA, PRC and India.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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