A United States cost–benefit comparison of an apodized, diffractive, presbyopia-correcting, multifocal intraocular lens and a conventional monofocal lens
Accepted 7 July 2008.
Purpose
To demonstrate the value, from the patient's perspective, of an apodized, diffractive, presbyopia-correcting multifocal intraocular lens (MF-IOL) compared to a conventional monofocal intraocular lens (CM-IOL).
Setting
Open-label, multi-site U.S. clinical trial.
Methods
A cost–benefit analysis was conducted using cataract patients' willingness-to-pay (WTP) for spectacle independence as the measure of economic benefit. WTP was elicited from participants in a clinical trial comparing a MF-IOL and a CM-IOL. Costs borne by patients were obtained from standard reference sources. A 14-year analytical timeframe was used, and a 3% annual discount rate was applied to both costs and benefits. The outcome of interest was net benefit (difference between benefits and costs). A probabilistic sensitivity analysis was used to confirm the robustness of the economic results.
Results
Four hundred ninety-five patients provided WTP estimates for spectacle independence (MF-IOL, n = 339; CM-IOL, n = 156). Eighty percent of all patients were willing to pay at least $5 per day to be spectacle independent. The incremental acquisition cost associated with bilateral implantation of 2 MF-IOLs was estimated at $4,000. Eighty percent in the MF-IOL group and 8% in the CM-IOL group reported post-operative spectacle independence. The net benefit was $11,670 in the MF-IOL group and $155 in the CM-IOL group. The probabilistic sensitivity analysis confirmed the robustness of the economic outcomes.
Conclusion
The net benefit of the MF-IOL exceeded its acquisition cost and the net benefit of the CM-IOL, demonstrating its value to select cataract patients willing to pay a premium for spectacle independence.
From California Eye Institute (Maxwell), Fresno, California; Alcon Laboratories (Waycaster, Hileman), Fort Worth, Texas; and Xcenda (Meissner, D'Souza), Palm Harbor, Florida, USA
Corresponding author: Curtis Waycaster, PhD, 6201 South Freeway, TC-41, Fort Worth, Texas 76134-2099, USA.
Dr. Maxwell served as a medical monitor for the clinical trial that collected the willingness-to-pay data. Additionally, he is a paid consultant to Alcon Laboratories. However, Dr. Maxwell was not directly compensated for his participation in this manuscript nor does he have a direct financial interest in the presented results. Drs. Waycaster and Hileman are employees of Alcon Laboratories. Drs. Meissner and D'Souza are employees of Xcenda, which provides consulting services to Alcon Laboratories.
Presented at the 12th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes Research, Arlington, Virginia, USA, May 2007.
Supported by a grant from Alcon Laboratories, Inc., Fort Worth, Texas, USA.
ABSTRACT