Femtosecond cataract surgery not more cost-effective than conventional phaco
Investigators conducted a retrospective cost-effectiveness analysis of femtosecond laser-assisted cataract surgery and phacoemulsification cataract surgery in a hypothetical cohort of patients. They converted visual acuity outcomes to utility values based on quality-adjusted life-years (QALYs).
Costs were calculated using Medicare Benefits Scheme schedule fees, Australian Medical Association recommended fees, national hospital cost reports, private health insurance company annual reports and current industry standards. Fees for facilities, anesthesia, various IOL types and spectacles were also calculated.
Femtosecond surgery had a net utility gain of 0.01 over conventional phaco, based on simulated complication rates for both methods and a 5% improvement in visual acuity with femtosecond surgery. It had a total QALY gain of 0.06 units over phaco.
Femtosecond surgery was considered most cost-effective when all patients had best corrected visual acuity of 6/12 or better, cost to the patient was reduced to $300, and cystoid macular edema, corneal decompensation and lens dislocation were eliminated.
“This resulted in an [incremental cost-effectiveness ratio] of $20,000/QALY,” the study authors said. “Despite the economic model being hypothetical, it shows that optimistic potential benefits of [femtosecond laser-assisted cataract surgery] technology are not cost-effective at its current cost to patients.”
Disclosure: The study authors have no relevant financial disclosures.