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British Journal of Ophthalmology 2004;88:1163-1168
© 2004 BMJ Publishing Group Ltd

EXTENDED REPORT

Cost effectiveness of foldable multifocal intraocular lenses compared to foldable monofocal intraocular lenses for cataract surgery

M G T Dolders1,2, M D Nijkamp2,3, R M M A Nuijts4, B van den Borne2,5, F Hendrikse3,4, A Ament1,2, W Groot1,2

1 Maastricht University, Department of Health Organisation, Policy and Economics (HOPE), Maastricht, Netherlands
2 Care and Public Health Research Institute (CAPHRI), Maastricht, Netherlands
3 Eye Research Institute Maastricht (ERIM), Maastricht, Netherlands
4 University Hospital Maastricht, Department of Ophthalmology, Maastricht, Netherlands
5 Maastricht University, Department of Health Education, Maastricht, Netherlands

Correspondence to:
Correspondence to:
M G T Dolders, MHSc
Maastricht University, Department of Health Organisation, Policy and Economics - UNS 40, PO Box 616, 6200 Maastricht, Netherlands; m.dolders{at}beoz.unimaas.nl

Aim: To analyse the cost effectiveness of foldable monofocal intraocular lenses (IOLs) compared to foldable multifocal IOLs in cataract surgery alongside a prospective, multicentre randomised clinical trial (RCT).

Methods: Patients underwent cataract surgery with bilateral monofocal (n = 97) or multifocal (n = 93) IOL implantation. Cost data and patient preferences, using the visual analogue scale (VAS), the time trade-off (TTO), and the standard gamble (SG) technique were obtained preoperatively and postoperatively by structured interviews. The incremental costs (multifocal minus monofocal), mean costs per patient, and differences in preferences were computed.

Results: Mean costs for glasses per patient in the monofocal group were {euro}41.67 and in the multifocal group {euro}149.58. The difference in costs between the multifocal and monofocal group was {euro}–92.09 and was statistically significant (p = 0.008). No significant differences were found in total costs or in effectiveness between the monofocal and multifocal IOL group.

Conclusion: The cost effectiveness of multifocal IOLs is reduced to a cost minimisation analysis, because of the inability to demonstrate significant differences in effects. The use of multifocal IOLs in cataract surgery resulted in a significant reduction in costs for patient’s postoperative spectacles.

Abbreviations: CEA, cost effectiveness analysis; CUA, cost utility analysis; HRQoL, health related quality of life; IOLs, intraocular lenses; QALYs, quality adjusted life years; RCT, randomised clinical trial; SG, standard gamble; TTO, time trade-off; VAS, visual analogue scale

Keywords: cost effectiveness; multifocal lenses; cataract surgery

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