Value-based medicine and ophthalmology: an appraisal of cost-utility analyses.
OBJECTIVE
To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format.


METHODS
Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances.


RESULTS
A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY.


CONCLUSIONS
The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.
Brown
Gary C
GC
Center for Value-Based Medicine, Flourtown, Pennsylvania, USA.
Brown
Melissa M
MM
Sharma
Sanjay
S
Brown
Heidi
H
Smithen
Lindsay
L
Leeser
David B
DB
Beauchamp
George
G
D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006801:Humans; D009885:Ophthalmology / Q000191:economics*; D017060:Patient Satisfaction