Meeting News Coverage

Costs calculated for vitrectomy claims

SEATTLE — In patients with newly diagnosed macular hole, only 24% had a vitrectomy performed within 1 year, according to a poster presented here.

Using Medicare claims data from 2008 to 2010, Sunil Srivastava, MD, and colleagues calculated the mean cost in claims for those patients to be $5,900 greater than for patients who did not have vitrectomy. Over 2 years, the average allowed charges for ophthalmic services per vitrectomy patient was $7,702.

“This cost shows the value of this surgery,” Srivastava told Ocular Surgery News at the Association for Research in Vision and Ophthalmology meeting, especially for a procedure that typically has a good outcome.

According to the claims data, 455 patients of 1,897 newly diagnosed cases of macular hole underwent vitrectomy within a year; 1,442 patients did not.

Srivastava said there are a variety of reasons that patients may not have undergone vitrectomy, but there is a “challenge in interpreting the claims data” to determine those reasons.

Cataract surgery was performed more often in those treated with vitrectomy than in those who did not have vitrectomy performed, and additional vitrectomy was performed in at least 15% of macular hole cases, Srivastava said.

The study was intended to set a baseline, Srivastava said. There may be therapeutic options developed that will cost less, but this study sets a monetary reference point.

Disclosure: Srivastava is a consultant for Bausch + Lomb.

SEATTLE — In patients with newly diagnosed macular hole, only 24% had a vitrectomy performed within 1 year, according to a poster presented here.

Using Medicare claims data from 2008 to 2010, Sunil Srivastava, MD, and colleagues calculated the mean cost in claims for those patients to be $5,900 greater than for patients who did not have vitrectomy. Over 2 years, the average allowed charges for ophthalmic services per vitrectomy patient was $7,702.

“This cost shows the value of this surgery,” Srivastava told Ocular Surgery News at the Association for Research in Vision and Ophthalmology meeting, especially for a procedure that typically has a good outcome.

According to the claims data, 455 patients of 1,897 newly diagnosed cases of macular hole underwent vitrectomy within a year; 1,442 patients did not.

Srivastava said there are a variety of reasons that patients may not have undergone vitrectomy, but there is a “challenge in interpreting the claims data” to determine those reasons.

Cataract surgery was performed more often in those treated with vitrectomy than in those who did not have vitrectomy performed, and additional vitrectomy was performed in at least 15% of macular hole cases, Srivastava said.

The study was intended to set a baseline, Srivastava said. There may be therapeutic options developed that will cost less, but this study sets a monetary reference point.

Disclosure: Srivastava is a consultant for Bausch + Lomb.

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