Abstract
To evaluate phacoemulsification platforms based on cost-effectiveness approach in the Russian Federation. We tested cost-effectiveness approach for evaluation of four phacoemulsification platforms: Centurion by Alcon Inc., Stellaris and Stellaris PC (StPC) by Bausch&Lomb and Visalis 500 (Vis500) by Zeiss. Usually cost-effectiveness evaluation assumes use of effectiveness criteria, that is relevant to patient’s outcome. Therefore, we determined effectiveness criteria as cumulative dissipated energy (CDE, seconds) during operation for each of platforms, as CDE is associated with patient’s safety. The data on effectiveness of the platforms were obtained from expert assessment. The reason for using these effectiveness criteria and data source was the lack of data of relevant to cost-effectiveness evaluation comparable data in clinical trials for each of platforms. As we have made cost-effectiveness evaluation for phacoemulsification platforms, we considered only direct costs for them. The source of the costs was public data of government procurement average prices for the period of 2016-2018 years Exchange rate was €1 = 72 Rub. Expert assessment, provided by the head doctor of the largest ophthalmic center in the Russian Federation (S.N. FEDOROV NMRC “MNTK “EYE MICROSURGERY”), have shown, that CDE was 3, 10, 10 and 20 for Centurion, Stellaris, StPC and Vis500, respectively. Centurion demonstrated the lowest value of CDE. Platform’s costs were €73311, €43426, €75074 and €61478 for Centurion, Stellaris, StPC and Vis500, respectively. ICERs for Centurion were €4263, €250 and €694 compare to Stellaris, StPC and Vis500, respectively. Calculated ICERs for Centurion demonstrates relatively small incremental costs for its advantages compare to same generation platform StPC and Vis500. We performed quantitative cost-effectiveness evaluation for phacoemulsification platform, nevertheless more relevant effectiveness criteria is still required to become more robust evidence in decision-making.
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