A Value-Baed Medicine Cot-Utility Analyi of Idiopathic Epiretinal Membrane urgery Original Reearch Article

Purpoe To perform a reference cae, cot-utility analyi of epiretinal membrane (ERM) urgery uing current literature on outcome and complication. Deign Computer-baed, value-baed medicine analyi. Method Deciion analye were performed under two cenario: ERM urgery in better-eeing eye and ERM urgery in wore-eeing eye. The model applied long-term publihed data primarily from the Blue Mountain Eye tudy and the Beaver Dam Eye tudy. Viual acuity and major complication were derived from 25-gauge par plana vitrectomy tudie. Patient-baed, time trade-off utility value, Markov modeling, enitivity analyi, and net preent value adjutment were ued in the deign and calculation of reult. Main outcome meaure included the number of dicounted quality-adjuted-life-year (QALY) gained and dollar pent per QALY gained. Reult ERM urgery in the better-eeing eye compared with obervation reulted in a mean gain of 0.755 dicounted QALY (3% annual rate) per patient treated. Thi model reulted in $4,680 per QALY for thi procedure. When enitivity analyi wa performed, utility value varied from $6,245 to $3,746/QALY gained, medical cot varied from $3,510 to $5,850/QALY gained, and ERM recurrence rate increaed to $5,524/QALY. ERM urgery in the wore-eeing eye compared with obervation reulted in a mean gain of 0.27 dicounted QALY per patient treated. The $/QALY wa $16,146 with a range of $20,183 to $12,110 baed on enitivity analye. Utility value ranged from $21,520 to $12,916/QALY and ERM recurrence rate increaed to $16,846/QALY baed on enitivity analyi. Concluion ERM urgery i a very cot-effective procedure when compared with other intervention acro medical ubpecialtie.