The cost of vision for vitreoretinal interventions

Abstract

This article reviews the current status of treatments for age-related macular degeneration from a cost-effectiveness perspective. Treatments are now available to a broad range of patients with age-related macular degeneration, but they are pharmaceutical based and require repeated evaluation and treatment. The resulting unprecedented levels of cost make cost-effectiveness considerations more prescient. Newer methods to evaluate cost-effectiveness and treatment outcomes have included utility and value-based analyses. These have attempted to utilize accurate, objective parameters, but are calibrated by subjective patient assessments and are limited by certain methodological assumptions. Treatment methods to improve outcomes are increasingly being considered within the context of cost-effectiveness. Although improved understanding of basic, cellular processes has led to markedly improved treatment options for age-related macular degeneration within the past decade, the high costs and wide applicability threaten the balance and viability of the payor system. Accurate means of assessing cost-effectiveness are critical to defining clinical applications.