Modelling lifetime cost consequences of ReSTOR in cataract surgery in four European countries.
BACKGROUND
To compare the lifetime costs of liberating patients from spectacles after cataract surgery by implanting the multifocal intraocular lens (IOL) 'ReSTOR' versus monofocal IOLs in France, Italy, Germany and Spain.


METHODS
A Markov model was created to follow patient cohorts from cataract surgery until death. Prevalence rates of patients not needing spectacles after cataract surgery were obtained from clinical trials. Resource utilisation included implant surgery, IOLs, spectacles, visits to ophthalmologists and eye centres, transport, and time lost by patients. Economic perspectives were those of Society and Sickness Funds (SFs).


RESULTS
The mean number of spectacles purchased after ReSTOR was 1.34-1.61 and after monofocal IOLs 6.05-7.27. From the societal perspective, total cost estimates discounted by 3% were between 3,551 euros and 4,052 euros with ReSTOR compared to 3,989 euros and 5,548 euros with monofocal IOLs. Undiscounted savings related to ReSTOR ranged from 815 euros to 2,164 euros. From the SFs' perspective total cost estimates discounted by 3% were between 2,150 euros and 2,524 euros with ReSTOR compared to 2,324 euros and 2,610 euros with monofocal IOLs. Savings related to ReSTOR, once costs discounted, ranged from 61 euros to 219 euros. Discount and spectacle freedom prevalence rates were the most sensitive parameters.


CONCLUSIONS
The bulk of the savings related to ReSTOR were realized outside the SF. From both a societal and SF perspective, savings, after a 3% discounting, achieved by liberating patients from spectacles counterbalanced the initially higher cost of ReSTOR. ReSTOR is a cost saving alternative to spectacles for patients requiring cataract surgery.
Lafuma
Antoine
A
Cemka, 43 boulevard du maréchal Joffre, F-92240 Bourg-la-Reine, France. antoine.lafuma@cemka.fr
Berdeaux
Gilles
G
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000191:economics* / Q000379:methods; D003365:Costs and Cost Analysis; D005060:Europe; D005139:Eyeglasses / Q000191:economics / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000191:economics*; D007910:Lenses, Intraocular / Q000191:economics* / Q000706:statistics & numerical data; D008390:Markov Chains; D018803:Models, Economic