PD09 Comparing Long-term Costs Associated With Intraocular Lens Selection And Nd:YAG Laser Capsulotomy In The UK: A Cost-Consequence Analysis

Abstract

IntroductionCataract surgery is the most frequently performed surgical procedure in the UK and posterior capsule opacification (PCO) is the most common complication post-surgery. Nd:YAG capsulotomy is the standard of care for treating PCO, although it bears a cost and is also associated with complications. The objective of this research was to estimate costs from a budget holders perspective associated with PCO related, post-cataract surgery resource use, comparing different single-piece intraocular lenses (IOLs) and utilizing results from a recently published audit of PCO incidence in the UK (n=601,084).MethodsThis research adapts the findings of the aforementioned audit to develop a cost-consequence analysis. The model is underpinned by the Nd:YAG rates of the included single-piece acrylic IOLs at 5 years. Nd:YAG related additional consultations and reported complications of the procedure were also included as variables of efficiency in the model. Estimates are presented from the perspective of a hospital setting in the UK, performing 3,000 cataract surgeries annually and extrapolated out to the broader cataract population (n=472,000). Costs were sourced from NHS Tariff documentation.ResultsAcrySof IQ was associated with lower Nd:YAG procedures and additional consultations at 5 years post-cataract surgery compared to all other single-piece monofocal acrylic lenses included in UK Audit Report. Assuming 3,000 cataract surgeries carried out annually, this translated into potential cost savings for the AcrySof IQ lens ranging from GBP 7,993 (EUR 9,379) (versus Eyecee One) to GBP 194,502 (EUR 228,243) (versus Akreos Adapt). Extrapolating to the broader population cataract patients in the UK would provide for a cost-saving estimates in the region of GBP 1.25 to GBP 30.6 million (EUR 1.47 to EUR 35.91 million).ConclusionsThis economic analysis highlights that the appropriate choice of IOL for cataract surgery, as a direct consequence of lower ND:YAG capsulotomy rates may translate into significant savings both for UK hospitals and the national healthcare system.