PMD40 Comparing the LONG-TERM Costs Associated with Intraocular LENS Selection and ND:YAG Laser Capsulotomy Post-Cataract Surgery: A Cost-Consequence Analysis from a Spanish Healthcare System Perspective

Abstract

Posterior capsule opacification (PCO) is the most common post-surgical complication of cataract surgery, incidence figures ranging from <5% to as high as 50%. Visually significant PCO is treated by Nd:YAG laser capsulotomy, which bears a cost and its provision can place a burden on health care systems. The objective of this research was to estimate costs from a budget holders perspective associated with PCO related post-cataract surgery resource use in a typical hospital setting – comparing different single-piece intraocular lenses (IOLs) and utilizing findings from a real-world evidence (RWE) study in Spain This research adapts the findings of the aforementioned RWE study to include a cost-consequence analysis. The model is underpinned by the Nd:YAG rates of the included IOLs at 3 years: AcrySof (5%), Zeiss Asphina (21.2%), IOL Tech (23.2%), Medicontur (23.1%) and AJL IOLs (31.1%). The 2 associated consultations required within the first 6 months period post Nd:YAG, were also included as variables of efficiency in the model. Costs were sourced from Valencian Community tariffs (2016-2018). AcrySof was associated with significantly lower Nd:YAG procedures and additional consultations, 3 years post-cataract surgery compared to all other lenses included in the model. Assuming 2,000 cataract surgeries carried out in one year, this translated into potential cost savings for the eAcrySof lens, over 3 years, ranging from €108,060 (versus Zeiss Asphina) to €174,097 (versus AJL). Moreover, assuming 20 minutes for the Nd:YAG laser appointment and associated consultations, the time saved estimate ranged from 40.2 to 64.8 working days for the hospital. This economic analysis of real world treatment outcomes 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 financially and with respect to resource use for Spanish hospitals and the national healthcare system.