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Indian Journal of Clinical Anatomy and Physiology


Retrospective pharmacoeconomic evaluation of two types of cataract surgeries in a private hospital: cost effectiveness analysis


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Author Details: Shilpa Deshpande, Abhijeet Deshpande, Prashant Amale

Volume : 2

Issue : 2

Online ISSN : 2394-2126

Print ISSN : 2394-2118

Article First Page : 55

Article End Page : 59


Abstract

Objective: Cataract surgery is performed by two methods; small incision cataract surgery (SICS) and topical phacoemulsification (TPE) with intraocular lens (IOL) implantation. SICS is a widely used method but technological advances have led to increasing use of TPE. Both procedures require different capital investment. Pharmacoeconomic evaluation tends to investigate the selection and use of treatment program to make the patient medication efficient, safe and economical. The objective of the present study was to evaluate the economics and effectiveness of SICS and TPE.
Materials and Method: Records of 800 patients in a private hospital over last 5 years were retrospectively analyzed. Patients were selected with inclusion and exclusion criteria and divided into two groups; SICS (n= 350) and TPE (n=450). Follow up was done after day 1; 1, 4, 8 weeks and 2 years. The cost was calculated including direct and indirect medical and non-medical costs. Outcomes were determined according to economical benefit, surgical benefits and humanistic outcomes as per SF-36 questionnaire with slight modifications. The cost effectiveness ratio (CER) was calculated with the help of QALY and utility values.
Results: Average cost of SICS and TPE over the period of 5 years was approximately Rs. 21220 and Rs. 30670 respectively. The QALY scores of patients in TPE group were significantly higher as compared to SICS group. CER was found to be lesser with TPE.
Conclusion: Retrospective pharmacoeconomic study revealed that TPE, although having higher cost, was clinically superior and cost effective than SICS as indicated from the analysis of consequences and CER.

Keywords:
Pharmacoeconomic evaluation, small incision cataract surgery, topical phacoemulsification, cost effectiveness analysis