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Purpose To perform a cost-utility analysis of 2018 United States real dollars for cataract surgery. Setting Center for Value-Based Medicine, Hilton Head, South Carolina, USA. Design Cost-utility analysis. Methods A base-case 14-year cost-utility model using the ophthalmic cost perspective was used. Third-party insurer and societal cost perspectives were also analyzed. Patient outcomes and costs were discounted with net present value analysis at 3% a year. Results First-eye cataract surgery resulted in a 2. 523 quality-adjusted life-year (QALY) gain, a 33. 3% patient value gain, and 25. 5% quality-of-life gain. Bilateral surgery yielded a 44. 1% patient value gain, while second-eye cataract surgery alone conferred an 8. 1% value gain. First-eye cataract surgery resulted in a gain of 2. 52 QALYs, while second-eye surgery added an incremental gain of 0. 81 QALYs. The ophthalmic-cost-perspective average cost-utility ratio was 2526/2. 523 = 1001/QALY for first-eye cataract surgery. The societal-cost-perspective average cost-utility ratio was −370 018/2. 523 = −146 629/QALY. The second-eye ophthalmic-cost-perspective cost-utility ratio was 2526/0. 814 = 3101/QALY, while the ophthalmic-cost-perspective cost-utility ratio for bilateral cataract surgery was 5052/3. 338 = 1514/QALY. The 14-year U. S. 2018 real-dollar societal-cost-perspective net return on investment for first-eye cataract surgery was 370 018 above the 2526 cost expended for cataract surgery. Conclusions Cataract surgery in both the first eye and second eye, when analyzed by standard health economic methodologies, is highly cost-effective. Cataract surgery in 2018 was 73. 7% more cost-effective than in 2000.
Brown et al. (Fri,) studied this question.