title: The cost-effectiveness of grid laser photocoagulation for the treatment of diabetic macular edema: results of a patient-based cost-utility analysis.
abstract: Grid laser therapy has been demonstrated to be of benefit for the treatment of diabetic macular edema. The purpose of the present study was to determine the cost-effectiveness of grid laser therapy for the treatment of diabetic macular edema. The analysis was performed from the perspective of a third-party insurer. Decision analyses and cost-effectiveness analyses were performed by incorporating the data from the Early Treatment Diabetic Retinopathy Study, expected longevity data, and patient-based utilities. Various sensitivity analyses were performed to determine the robustness of the models. Laser treatment conferred an overall improvement in quality-of-life adjusted years of approximately 3 months over the duration of disease for a hypothetical patient. The unadjusted cost per quality-of-life adjusted year (QALY) was US$3,101. Net present value analysis demonstrated that the cost per QALY could increase to $3,655, assuming a 5% discount rate. Overall, grid laser photocoagulation for diabetic macular edema is a very cost-effective treatment based on the results of this cost-utility analysis.
authors.affiliation: Unit for Cost-Effective Ocular Health Policy, Hotel Dieu Hospital, Kingston, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: G C
authors.initials: GC
authors.lastname: Brown
authors.forename: M M
authors.initials: MM
authors.lastname: Brown
authors.forename: H
authors.initials: H
authors.lastname: Hollands
authors.forename: G K
authors.initials: GK
authors.lastname: Shah
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D003930:Diabetic Retinopathy / Q000191:economics* / Q000401:mortality / Q000601:surgery; D006801:Humans; D017075:Laser Coagulation / Q000191:economics*; D008269:Macular Edema / Q000191:economics* / Q000401:mortality / Q000601:surgery; D017059:Models, Econometric; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D015996:Survival Rate; D014792:Visual Acuity