Table 4.
Effectiveness Indexes and Outcome Statistics
| Main Effectiveness Indexes | |||||||
|---|---|---|---|---|---|---|---|
| Authors | Effectiveness Indexes | Measurement Methods | Costs | Outcomes | |||
| Smith AF et al. | Clinical success rate of each alternative | Retrospective clinical studies performed in the four countries | IOL and its implantation, IOL material, Nd:YAG laser therapy and its complications | Hydrophobic acrylic 175.29 French Cost/success (€) 184.85 Spanish Cost/success (€)348.8 Italian Cost/success (€) 230.6 German Cost/success (€) | PMMA 240.85 French Cost/success (€) 208.19 Spanish Cost/success (€) 418.88 Italian Cost/success (€) 201.41 German Cost/success (€) | Hydrophobic acrylic 326.35 French Cost/success (€) 426.78 Spanish Cost/success (€) 539.77 Italian Cost/success (€) 388.72 German Cost/success (€) | Silicone222.38 French Cost/success (€) 245.42 Spanish Cost/success (€)408.33 Italian Cost/success (€) 253.68 German Cost/success (€) |
| Maxwell WA et al. | WTP | An open-label multi-site US clinical trial | Reading glasses, distance glasses, bifocal glasses | MF IOL $11,670 | CM-IOL $155 | ||
| Lafuma A et al. | Prevalence rates of patients not needing spectacles after cataract surgery | Clinical trials | Implant surgery, IOLs, spectacles, visits to ophthalmologists and eye centers, transport, and time lost by patients | ReSTOR | Monofocal IOLs | ||
| Societal perspective | €3551–€4052 | Societal perspective | €3989–€5548 | ||||
| SFs' perspective | €2150–€2524 | SFs' perspective | €2324–€2610 | ||||
| Pineda R et al. | UCVA QALY | A prospective study Weighted by utility values to derive (Utility = 0.37 × UCVA +0.514)28 | Surgery, additional costs for toric IOL and intraoperative limbal relaxing and peripheral corneal relaxing incision procedures, the total cost not reimbursed | Toric IOL −349 Incremental cost/QALY −393 Incremental cost/per patient with UCVA of 20/40 or better | Conventional monofocal IOL with intraoperative LRI/PCRI 3851 Incremental cost/QALY 3866 Incremental cost/per patient with UCVA of 20/40 or better | ||
| De Vries NE et al. | Spectacle independence rates VA | A randomized clinical trial | Spectacles, cataract surgery, IOLs, visits to ophthalmologists, optometrists, transport, and spectacle cleaning materials | Spectacle independence rates Lifetime discounted costs for the societyLifetime discounted costs for the NHS | ReSTOR86.0%€ 3,969€ 2,415 | monofocal IOLs8.7%€ 4,123€ 2,555 | Array-SA408.5%€ 5,326€ 2,556 |
| Lin JC et al. | Vision-related QOL | 25-item Visual Function Questionnaire (VFQ-25) developed by the National Eye Institute (NEI) | Spectacles, IOLs | Spectacle-independence rates Cost/spectacle-independence rate | Monofocal IOL, SA60AT31.80% — | Aspheric Multifocal IOL, ZM90089.50% 58.8 $/% | Aspheric Multifocal IOL, ReSTOR IQ90.90% 57.4 $/% |
| Spectacle independence rates | The number of those who were without spectacles at near and far distances | ||||||
| Kristianslund O et al. | CDVA (logMAR) QALYVF-14 | Published study29The utility values and a life expectancy30Visual Function-14 questionnaire | Equipment not used as a routine for both surgical techniques, a new IOL, surgical complications, additional operations and postoperative follow-up | Mean group difference (repositioning versus exchange)−281.20/−0.11 $/logMAR−1108/QALY $/QALY | 95% CI of group difference [lower; upper][−281.20/−0.29; +281.20/0.08][−406/QALY; +1522/QALY] | ||
| Hu JQ et al. | QALY | Published papers31–33 | IOLs and implantation, surgery and IOL exchange, ambulatory surgery fees, anesthesia fee, outpatient clinic fees and spectacles |
Multifocal IOLsMonofocal IOLs | A total lifetime QALY17.66 16.95 | The total cost$13,276.62 (societal perspective)$12,462.73 (health care perspective)$9,861.72 (societal perspective) $9,060.36 (health care perspective) | ICER (Multifocal IOLs vs. Monofocal IOLs)$4,804.63/QALY |
| Simons RWP et al. | HRQLUDVA/CDVADistance spectacle independence | Health Utilities Index Mark 3 (HUI3, Health Utilities Inc.)Published study34A questionnaire on spectacle use | Operating room time, IOL type, hospital daycare admissions, outpatient visits, complications, medication use, general practitioner visits, homecare, spectacles, travel, informal care, and productivity losses | Monofocal IOL from societal perspectiveToric IOL from societal perspective | Mean costs€ 2,796€ 3,319€ 3,203€ 3,456 | Mean effects0.31/QALY 6-mo follow-up7.64/QALY lifetime extrapolation0.30/QALY 6-mo follow-up7.03/QALY lifetime extrapolation | ICER——InferiorInferior |
| QALY | Determining the area under the curve of subsequent utility measurements (Utilities calculated by a multiplicative multi-attribute utility function.35) | Monofocal IOL from healthcare perspectiveToric IOL from healthcare perspective | € 2,292€ 2,927 | 0.32/Spectacle independence0.33/Binocular UDVA 0.10 logMAR or better0.80/Spectacle independence0.56/Binocular UDVA 0.10 logMAR or better | ——1310/patient2758/patient | ||
| Bala C et al. | QALY | The length of life multiplied by the utility weight36–37 | DFT015 IOL and SN60WF IOL, cataract surgery (including surgeon's fee and hospital fee), and glasses (reading glasses, distance glasses, bifocal glasses, varifocal glasses) | DFT015 IOLSN60WF IOL | Total costAU $7528AU $7221 | Total accrued lifetime QALY10.84510.684 | ICER (DFT015 IOL vs SN60WF IOL)AU $1908/QALY |
| Ranno S et al. | VF-14CDVA | Visual Function-14 questionnaireSnellen chart and converted to a logarithm of the minimum angle of resolution (logMAR) visual acuity | Surgery, postoperative complications | CDVA (logMAR)VF-14ECD (cell/mm2)ICER | SF-IOL Group0.24 ± 0.1768 ± 181456 ± 525€3.30/ECD | AC-IOL Group0.32 ± 0.2661 ± 201341 ± 374 | P value0.270.240.52 |
| ECD | Tomey EM-3000 noncontact specular microscope (Tomey, Nagoya, Aichi, Japan) by the semi-automated technique | ||||||
| HQO | QALY | Based on average utility values of cataract patients in Canada38 | Total hospital costs, physician, and equipment/consumables fees | MultifocalMonofocalHydrophobic acrylicSilicone | Cost$755.46$55.46$755.46$815.27 | Effect (QALY)8.9027798.8192438.9027798.902654 | Cost per QALY$8,380Dominant |
| HTAIn | QoLQALY Vision-related QOL | Euroqol's EQ5D-5L questionnaireA separate primary study IND VFQ 33 | Human Resource (HR) /labor, Non Consumables including Equipment, Furniture and fixtures, Infrastructure, Consumables including drugs and medicines and Overhead (Electricity and water bills, dietetics and laundry and maintenance charges) |
Phacoemulsification with Foldable lens vs. SICS with rigid lens | ICER3862.79 INR/ QALY | Incremental Net Health Benefit:0.55 QALY | Incremental Net Monetary Benefit:63255.2 INR |