title: Financial return-on-investment of ophthalmic interventions: a new paradigm.
abstract: OBJECTIVE
  Although the patient value gain (improvement in quality-of-life and/or length-of-life) has been highlighted in Value-based Medicine cost-utility analyses, the financial value gain associated with healthcare interventions has received less emphasis. It is important for professional healthcare providers to realize their interventions often confer a large financial return-on-investment (ROI) to society.
  
  
  RESULTS
  The societal costs associated with vitreoretinal and other ophthalmic interventions include: direct ophthalmic medical costs expended (hospital, physician, drug, diagnostic testing and so forth), direct medical costs saved (decreased costs for depression, injury, skilled nursing facility, nursing home and others), direct nonmedical costs saved (decreased costs for caregivers, transportation, residence costs, moving costs, and others), and indirect medical costs saved (improving employment incidence and wages). The financial ROI for direct ophthalmic medical costs expended for ranibizumab therapy for neovascular age-related macular degeneration is 450%, whereas that for cataract surgery is 4500% and for medical open-angle glaucoma therapy is 4000%. Many costs gained add to the Gross Domestic Product and increase the wealth of the nation.
  
  
  CONCLUSIONS
  Many vitreoretinal and other ophthalmologic interventions confer considerable patient value, but also result in a large financial ROI to society. This financial ROI increases the wealth of the nation.
authors.affiliation: aCenter for Value-Based Medicine, Flourtown bThe Research Department, Wills Eye Hospital, Jefferson Medical College, Philadelphia cEye Research Institute, Philadelphia dThe Retina Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Brown
authors.forename: Gary C
authors.initials: GC
authors.lastname: Brown
authors.forename: Heidi B
authors.initials: HB
authors.lastname: Lieske
authors.forename: P Alexander
authors.initials: PA
authors.lastname: Lieske
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000191:economics; D002387:Cataract Extraction / Q000191:economics; D003362:Cost-Benefit Analysis; D004180:Direct Service Costs; D004470:Economics, Medical; D005902:Glaucoma, Open-Angle / Q000191:economics; D006801:Humans; D008268:Macular Degeneration / Q000191:economics; D009885:Ophthalmology / Q000191:economics*; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D000069579:Ranibizumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab