Cost Utility and Value of Information Analysis of Femtosecond Laser–Assisted Cataract Surgery

• DOI: 10.1001/jamaophthalmol.2023.1716
• Publication Date: 2023-05-18T15:02:38Z
• Authors: Antoine Bénard; Remi Sitta; Antoine Pierre Br...; Beatrice Cochener; Dominique Monnet; Philippe Denis; Pierre-Jean Pisella; Nathalie Hayes; Cedric Schweitzer; ; Laurent Piazza; Nicolas Georges; Stéphanie Roseng; Anne Gimbert; Sophie Regueme; Jérome Galet; Fabien Daniel; Joseph Colin; David Touboul; Olivier Chatoux; Emilie Bardet; Catherine Bourreau; Romain Nicolau; Margaux Guillard; Catherine Cochard; Emilie Merce; Florence Galliot; Laurent Kodjikian; Minh Nguyen; Vincent Fortoul; Jean Rateau; Guillaume Vandenmeer; Thomas Habay; Jean-Louis Arné; Jean-Jacques Sarr...; Cati Albou-Ganem
• Keywords: Male; Phacoemulsification; Lasers; Visual Acuity; Humans; Female; Laser Therapy; Cataract Extraction; Cataract; Aged

Importance The efficacy and safety of femtosecond laser–assisted cataract surgery is well documented. An important requirement for decision makers the evaluation cost-effectiveness (FLACS) over a sufficiently long horizon. Evaluating this treatment was preplanned secondary objective Economic Evaluation Femtosecond Laser Assisted Cataract Surgery (FEMCAT) trial. Objective To estimate cost utility FLACS compared with phacoemulsification (PCS) on 12-month time Design, Setting, Participants This multicenter randomized clinical trial PCS in parallel groups. All procedures were performed using CATALYS precision system. recruited treated ambulatory settings 5 university-hospital centers France. consecutive patients eligible unilateral or bilateral 22 years older written informed consent included. Data collected from October 2013 to 2018, data analyzed January 2020 June 2022. Interventions PCS. Main Outcomes Measures Utility measured through Health Index questionnaire. Costs estimated by microcosting. inpatient outpatient costs French National System. Results Of 870 patients, 543 (62.4%) female, mean (SD) age at 72.3 (8.6) years. A total 440 receive 430 PCS; rate 63.3% (551 870). €1124.0 (€162.2; US $1235) €565.5 (€61.4; $621) care 12 months €7085 (€6700; $7787) participants €6502 (€7323; $7146) yielded 0.788 (0.009) quality-adjusted life-years (QALYs), 0.792 QALYs. difference €545.9 (95% CI, −434.1 1525.8; $600), QALYs −0.004 −0.028 0.021). incremental ratio (ICER) −€136 476 (US $150 000) per QALY. probability 15.7% threshold €30 000 $32 973) At threshold, expected value perfect information €246 139 079 $270 530 231). Conclusions Relevance ICER not within $50 $100 QALY range frequently cited as cost-effective. Additional research development needed improve its effectiveness lower price. Trial Registration ClinicalTrials.gov Identifier: NCT01982006