A United States cost-benefit comparison of an apodized, diffractive, presbyopia-correcting, multifocal intraocular lens and a conventional monofocal lens.
OBJECTIVE
To demonstrate the value, from the patient's perspective, of an apodized, diffractive, presbyopia-correcting multifocal intraocular lens (MF-IOL) compared to a conventional monofocal intraocular lens (CM-IOL).


METHODS
Open-label, multi-site U.S. clinical trial.


METHODS
A cost-benefit analysis was conducted using cataract patients' willingness-to-pay (WTP) for spectacle independence as the measure of economic benefit. WTP was elicited from participants in a clinical trial comparing a MF-IOL and a CM-IOL. Costs borne by patients were obtained from standard reference sources. A 14-year analytical timeframe was used, and a 3% annual discount rate was applied to both costs and benefits. The outcome of interest was net benefit (difference between benefits and costs). A probabilistic sensitivity analysis was used to confirm the robustness of the economic results.


RESULTS
Four hundred ninety-five patients provided WTP estimates for spectacle independence (MF-IOL, n = 339; CM-IOL, n = 156). Eighty percent of all patients were willing to pay at least $5 per day to be spectacle independent. The incremental acquisition cost associated with bilateral implantation of 2 MF-IOLs was estimated at $4,000. Eighty percent in the MF-IOL group and 8% in the CM-IOL group reported post-operative spectacle independence. The net benefit was $11,670 in the MF-IOL group and $155 in the CM-IOL group. The probabilistic sensitivity analysis confirmed the robustness of the economic outcomes.


CONCLUSIONS
The net benefit of the MF-IOL exceeded its acquisition cost and the net benefit of the CM-IOL, demonstrating its value to select cataract patients willing to pay a premium for spectacle independence.
Maxwell
William A
WA
California Eye Institute, Fresno, California, USA.
Waycaster
Curtis R
CR
D'Souza
Anna O
AO
Meissner
Brian L
BL
Hileman
Kendra
K
D000368:Aged; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005382:Financing, Personal; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000191:economics*; D008297:Male; D011305:Presbyopia / Q000191:economics* / Q000601:surgery; D011788:Quality of Life; D014481:United States