Costs and Healthcare Resource Utilization Associated with Posterior Capsule Opacification After Cataract Surgery with Five Different Intraocular Lenses: An Economic Analysis for Spain

Figures & data

Table 1 Average Time and/or Cost Required from Payers and Hospitals for the Nd:YAG Treatment and Related Complications ^a

Procedure Type	Total Events	Cost for Payer (EUR)	Time for Hospital HCP (mins)	Cost for Hospital HCP (EUR) ^b
Nd:YAG treatment only
Total for Nd:YAG treatment only	1647	€ 399,364.56 ^c	49,410 ^d	€ 30,091.00 ^e
Nd:YAG related complications within 6 months after Nd:YAG treatment
Cystoid macular oedema	11	€ 7,351.63	660	€ 401.94
Endophthalmitis	2	€ 2,277.08	160	€ 97.44
Hyphaema	1	€ 80.04	40	€ 24.36
IOL decentered/subluxed	4	€ 4,554.16	440	€ 267.96
Macular hole	5	€ 6,242.45	550	€ 334.95
Posterior vitreous detachment	36	€ 2,881.44	1440	€ 876.96
Raised Intraocular pressure	5	€ 400.20	200	€ 121.80
Reduction in vision	10	€ 800.40	400	€ 243.60
Retinal detachment	6	€ 7,029.12	660	€ 401.94
Retinal tear	1	€ 217.48	50	€ 30.45
Uveitis (Iridocyclitis)	1	€ 149.97	40	€ 24.36
Total for all complications	82	€ 31,984.00	4640	€ 2825.76
Nd:YAG treatment and related complications
Average costs	Per case	€261.90	32.82	€ 19.99

Notes: HCP, healthcare personnel, ^avalues are based on the 1647 YAG eyes within three years.²⁶ bCost of hospital specialist per minute is €0.609,²⁹ therefore Cost for hospital HCP = Time for hospital HCP × 0.609. ^cEach Nd:YAG treatment costs €242.48. ^dEach Nd:YAG treatment on average takes the hospital HCP 30 mins. ^eEach Nd:YAG treatment on average costs the hospital HCP €18.27 per case.

Table 2 Adjusted Nd:YAG Capsulotomy Incidence Rates for Different IOL Groups at Three Years Post-Cataract Surgery (Derived from Odd Ratios)²⁶

Production	Odd Ratio	LCI (95%)	UCI (95%)	Incidence Rate	LCI (95%)	UCI (95%)
AcrySof	Reference	NA	NA	5.00%	3.90%	6.10%
Zeiss Asphina	5.21	4.07	6.66	26.05%	20.35%	33.30%
IOL Tech	5.74	3.37	9.78	28.70%	16.85%	48.90%
Medicontur	5.86	4.5	7.62	29.30%	22.50%	38.10%
AJL LLASY60	8.85	6.82	11.47	44.25%	34.10%	57.35%

Abbreviations: LCI, lower confidence interval; UCI, upper confidence interval.

Table 3 Cost Savings per 2000 Cataract Eyes for the IOL Groups from the Payer Perspective

Comparison	Cost Savings (EUR)	Lower Value	Upper Value
AcrySof vs Zeiss Asphina	€ 110,259.90	€ 67,177.35	€ 169,396.92
AcrySof vs IOL Tech	€ 124,140.60	€ 50,677.65	€ 259,281.00
AcrySof vs Medicontur	€ 127,283.40	€ 77,312.88	€ 197,053.56
AcrySof vs AJL LLASY60	€ 205,591.50	€ 131,997.60	€ 307,968.21

Table 4 Time and Cost Savings per 2000 Cataract Eyes for the IOL Groups from the Hospital Perspective

Comparison	Time Savings (Hours)	Lower Value	Upper Value	Cost Savings (EUR)	Lower Value	Upper Value
AcrySof vs Zeiss Asphina	230.29	140.31	353.80	€ 8,415.79	€ 5,127.44	€ 12,929.53
AcrySof vs IOL Tech	259.28	105.84	541.53	€ 9,475.26	€ 3,868.07	€ 19,790.10
AcrySof vs Medicontur	265.84	161.47	411.56	€ 9,715.14	€ 5,901.05	€ 15,040.48
AcrySof vs AJL LLASY60	429.40	275.69	643.22	€ 15,692.15	€ 10,074.96	€ 23,506.24

Dhariwal M, Bouchet C, Jawla S. Comparing the long-term impact on health care resources utilization and costs due to various single-piece acrylic monofocal intraocular lens implantation during cataract surgery: a cost-consequence analysis for the United Kingdom, Italy, and Denmark. Clin Ophthalmol. 2019;13:169–176. doi:10.2147/OPTH.S190754

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Diari Oficial de la Generalitiat Valenciana. Num. 8020/ 30.12.2017. Available from: https://dogv.gva.es/datos/2017/12/30/pdf/2017_12159.pdf. Accessed August 17 2021.

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