Eine Plattform für die Wissenschaft: Bauingenieurwesen, Architektur und Urbanistik
Eine Plattform für die Wissenschaft: Bauingenieurwesen, Architektur und Urbanistik
Trial-based cost-effectiveness analysis of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus DSAEK
Purpose To evaluate the cost-effectiveness of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus standard DSAEK. Methods A cost-effectiveness analysis using data from a multicentre randomized clinical trial was performed. The time horizon was 12 months postoperatively. Sixty-four eyes of 64 patients with Fuchs' endothelial dystrophy were included and randomized to UT-DSAEK (n = 33) or DSAEK (n = 31). Relevant resources from healthcare and societal perspectives were included in the cost analysis. Quality-adjusted life years (QALYs) were determined using the Health Utilities Index Mark 3 questionnaire. The main outcome was the incremental cost-effectiveness ratio (ICER; incremental societal costs per QALY). Results Societal costs were euro9431 (US$11 586) for UT-DSAEK and euro9110 (US$11 192) for DSAEK. Quality-adjusted life years (QALYs) were 0.74 in both groups. The ICER indicated inferiority of UT-DSAEK. The cost-effectiveness probability ranged from 37% to 42%, assuming the maximum acceptable ICER ranged from euro2500-euro80 000 (US$3071-US$98 280) per QALY. Additional analyses were performed omitting one UT-DSAEK patient who required a regraft [ICER euro9057 (US$11 127) per QALY, cost-effectiveness probability: 44-62%] and correcting QALYs for an imbalance in baseline utilities [ICER euro23 827 (US$29 271) per QALY, cost-effectiveness probability: 36-59%]. Furthermore, the ICER was euro2101 (US$2581) per patient with clinical improvement in best spectacle-corrected visual acuity (>= 0.2 logMAR) and euro3274 (US$4022) per patient with clinical improvement in National Eye Institute Visual Functioning Questionnaire-25 composite score (>= 10 points). Conclusion The base case analysis favoured DSAEK, since costs of UT-DSAEK were higher while QALYs were comparable. However, additional analyses revealed no preference for UT-DSAEK or DSAEK. Further cost-effectiveness studies are required to reduce uncertainty.
Trial-based cost-effectiveness analysis of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus DSAEK
Purpose To evaluate the cost-effectiveness of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus standard DSAEK. Methods A cost-effectiveness analysis using data from a multicentre randomized clinical trial was performed. The time horizon was 12 months postoperatively. Sixty-four eyes of 64 patients with Fuchs' endothelial dystrophy were included and randomized to UT-DSAEK (n = 33) or DSAEK (n = 31). Relevant resources from healthcare and societal perspectives were included in the cost analysis. Quality-adjusted life years (QALYs) were determined using the Health Utilities Index Mark 3 questionnaire. The main outcome was the incremental cost-effectiveness ratio (ICER; incremental societal costs per QALY). Results Societal costs were euro9431 (US$11 586) for UT-DSAEK and euro9110 (US$11 192) for DSAEK. Quality-adjusted life years (QALYs) were 0.74 in both groups. The ICER indicated inferiority of UT-DSAEK. The cost-effectiveness probability ranged from 37% to 42%, assuming the maximum acceptable ICER ranged from euro2500-euro80 000 (US$3071-US$98 280) per QALY. Additional analyses were performed omitting one UT-DSAEK patient who required a regraft [ICER euro9057 (US$11 127) per QALY, cost-effectiveness probability: 44-62%] and correcting QALYs for an imbalance in baseline utilities [ICER euro23 827 (US$29 271) per QALY, cost-effectiveness probability: 36-59%]. Furthermore, the ICER was euro2101 (US$2581) per patient with clinical improvement in best spectacle-corrected visual acuity (>= 0.2 logMAR) and euro3274 (US$4022) per patient with clinical improvement in National Eye Institute Visual Functioning Questionnaire-25 composite score (>= 10 points). Conclusion The base case analysis favoured DSAEK, since costs of UT-DSAEK were higher while QALYs were comparable. However, additional analyses revealed no preference for UT-DSAEK or DSAEK. Further cost-effectiveness studies are required to reduce uncertainty.
Trial-based cost-effectiveness analysis of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus DSAEK
Simons, Rob W. P. (Autor:in) / Dickman, Mor M. (Autor:in) / van den Biggelaar, Frank J. H. M. (Autor:in) / Dirksen, Carmen D. (Autor:in) / Van Rooij, Jeroen (Autor:in) / Remeijer, Lies (Autor:in) / Van der Lelij, Allegonda (Autor:in) / Wijdh, Robert H. J. (Autor:in) / Kruit, Pieter J. (Autor:in) / Nuijts, Rudy M. M. A. (Autor:in)
01.12.2019
Simons , R W P , Dickman , M M , van den Biggelaar , F J H M , Dirksen , C D , Van Rooij , J , Remeijer , L , Van der Lelij , A , Wijdh , R H J , Kruit , P J & Nuijts , R M M A 2019 , ' Trial-based cost-effectiveness analysis of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) versus DSAEK ' , Acta ophthalmologica , vol. 97 , no. 8 , pp. 756-763 . https://doi.org/10.1111/aos.14126
Aufsatz (Zeitschrift)
Elektronische Ressource
Englisch
PENETRATING KERATOPLASTY , corneal transplantation , ultrathin Descemet stripping automated endothelial keratoplasty , cost-effectiveness , OUTCOMES , quality-adjusted life years , Descemet stripping automated endothelial keratoplasty , costs , POSTERIOR LAMELLAR KERATOPLASTY , Fuchs' endothelial dystrophy
DDC:
690
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