Cost-effectiveness of osteo-odonto keratoprosthesis in Singapore.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Dong, D; Tan, A; Mehta, JS; Tan, D; Finkelstein, EA

Published Date

  • January 2014

Published In

Volume / Issue

  • 157 / 1

Start / End Page

  • 78 - 84.e2

PubMed ID

  • 24083686

Pubmed Central ID

  • 24083686

Electronic International Standard Serial Number (EISSN)

  • 1879-1891

International Standard Serial Number (ISSN)

  • 0002-9394

Digital Object Identifier (DOI)

  • 10.1016/j.ajo.2013.08.004

Language

  • eng