ECONOMIC EVALUATIONS OF MEDICAL DEVICES IN CANADA: LENSX® FEMTOSECOND LASER-ASSISTED CATARACT SURGERY

• DOI: 10.1016/j.jval.2016.03.723
• Publication Date: 2016-05-23T12:53:36Z
• Authors: A. Lee; M.S. Keith; S. Prasad; M. Kohli; A. Ferreira; C. Bouchet
• Keywords: Spectacle

Economic evaluations of medical devices pose some inherent challenges such as the difficulty in conducting randomized controlled trials (RCTs) and additional evidence development post-launch. We developed a cost-effectiveness model to evaluate use LenSx® laser system for femtosecond laser-assisted cataract surgery (FLACS) compared phacoemulsification (PCS) medically necessary removal Canada. A decision analytic was designed determine quality-adjusted life-years (QALYs) gained costs from Canadian hospital perspective. Patients received monofocal or toric intraocular lens. Corrected distance visual acuity (CDVA), spectacle dependence, complication rates, CDVA utilities, dependence complications disutilities were obtained published literature; assumptions made cases unavailable data. Costs fit local setting. The ratios (ICERs) FLACS vs PCS $169,086/QALY, $37,790/QALY $18,099/QALY 1-year, 5-year lifetime (~13.6 years) time horizons, respectively. main difference observed clinical outcomes more patients remaining dependent FLACS. As assumed be comparable absence RCTs that showed difference, impact change horizon therefore due disutility applied dependence. ICER most sensitive changes mean age (affecting horizon), distribution efficacy parameters. Our analysis demonstrates is cost-effective treatment when PCS, but highlights need continuously re-evaluate given strength generation