A cot-utility analyi of intervention for evere proliferative vitreoretinopathy

PURPOE: The purpoe of thi tudy wa to report a reference cae, patient preference-baed, incremental, cot-utility analyi for treatment of retinal detachment aociated with evere proliferative vitreoretinopathy (PVR). DEIGN: Computer-baed economic model utilizing data from the Medicare health inurance ytem in the United tate. METHOD: A cot-utility analyi compared vitreoretinal urgery uing expanding gae and ilicone oil therapy to the natural coure of retinal detachment aociated with evere PVR. The model applie long-term publihed viual data from the ilicone tudy Group, time tradeoff utility analyi, deciion analyi with Markov modeling, and dicounting of cot and health benefit a per the Panel on Cot-Effectivene in Health and Medicine. The major outcome meaure wa in year 2000 United tate dollar per quality-adjuted life-year ($/QALY) gained. REULT: Vitreoretinal urgery for retinal detachment complicated by evere PVR, a compared with no treatment, reulted in a mean gain of 0.128–0.200 dicounted (3% annual rate) quality-adjuted life-year per treated patient. ilicone oil ($/QALY gained of $40,252) wa lightly more cot-effective than perfluoropropane (C3F8) ga ($/QALY gained of $46,926) in eye with PVR without previou vitrectomy, wherea C3F8 ga ($/QALY gained of $46,162) wa more cot-effective than ilicone oil ($/QALY gained of $62,383) with previou vitrectomy and PVR. enitivity analyi reulted in a $/QALY gained of $13,347 when 10% of oppoite eye had a evere viual lo to $202,128 when a dicount rate of 10% wa utilized and oppoite eye initially had good viion. CONCLUION: The incremental expene of intervention for retinal detachment aociated with PVR i cot-effective when compared with other widely accepted interventional therapie acro divere medical pecialtie.