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Pars plana vitrectomy most cost-effective for VMA, macular hole
Pars plana vitrectomy was the most cost-effective treatment for vitreomacular adhesion and full-thickness macular hole, according to study findings.
Researchers culled data from the MIVI-TRUST study and from published clinical trials on Jetrea (ocriplasmin, ThromboGenics/Alcon) for the treatment of vitreomacular adhesion and macular hole.
All treatment methods were presumed to yield a 2.5-line improvement in visual acuity if the anatomy was resolved. The researchers used cost data from the Centers for Medicare and Medicaid Services to calculate imputed costs for each primary treatment.
Primary outcome measures were imputed cost of therapy, cost per line saved, cost per line-year saved and cost per quality-adjusted life years (QALYs).
The analysis showed that when pars plana vitrectomy was the primary procedure, the overall imputed cost ranged from $5,802 to $7931. The cost per line ranged from $2,368 to $3,237. The cost per line-year saved was $163 to $233. The cost per QALY was $5,444 to $7,442.
When intravitreal injection of ocriplasmin was the primary procedure, the overall imputed cost ranged from $8,767 to $10,977. The cost per line ranged from $3,549 to $4,456, and the cost per line-year saved was $245 to $307. Cost per QALY ranged from $8,159 to $10,244.
When intravitreal saline injection was the main procedure, the overall imputed cost ranged from $5,828 to $8,098. The cost per line was $2,374 to $3,299. The cost per line-year ranged from $164 to $227, and the cost per QALY ranged from $5,458 to $7,583, according to the researchers.
Disclosure: The study was supported by grants from the National Institutes of Health, Research to Prevent Blindness and the U.S. Department of Defense.