Cost-benefit analysis of a trifocal intraocular lens versus a monofocal intraocular lens from the patient's perspective in the United States

PLoS One. 2022 Nov 3;17(11):e0277093. doi: 10.1371/journal.pone.0277093. eCollection 2022.

Abstract

Purpose: To conduct a cost-benefit analysis of AcrySof IQ PanOptix trifocal intraocular lens (TFNT00 IOL) versus AcrySof monofocal IOL (SN60AT) from the patient perspective in the United States (US).

Methods: A de novo Markov model was developed to estimate the mean total lifetime patient costs and vision-related quality of life (measured as quality adjusted life-years (QALYs)) with each intervention (TFNT00 and SN60AT) and the incremental differences between these two treatments. The resulting incremental quality of life gain was mapped to the US patient willingness to pay threshold of $50,000 per QALY gain to estimate the lifetime net monetary value, measured as the net monetary benefit of TFNT00 IOL. Model inputs (transition probabilities, costs, discount rate, utilities, and event rates) were derived from the FDA IDE study (NCT03280108), published literature, clinical experience, and other relevant sources.

Results: Bilateral cataract surgery with implantation of the advanced technology IOL (AT-IOL) TFNT00 provides improved vision-related quality of life (QALY gain of 0.67) at an incremental lifetime cost of $2,783 compared to monofocal IOL. This incremental QALY gain translated into a lifetime net monetary benefit of $30,941 at the patient willingness to pay threshold of $50,000/QALY gain. Results were most sensitive to disutility due to wearing glasses, patient out of pocket costs for bilateral AT-IOL procedure, and post-operative spectacle dependence rates.

Conclusions: AcrySof IQ PanOptix IOL provides greater improvement in vision related quality of life compared to no presbyopia correction with a monofocal IOL. This study shows PanOptix is a cost-beneficial treatment strategy for patients willing to pay out of pocket for cataract surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cataract* / etiology
  • Cost-Benefit Analysis
  • Humans
  • Lens Implantation, Intraocular / methods
  • Lenses, Intraocular*
  • Phacoemulsification*
  • Prosthesis Design
  • Quality of Life
  • United States
  • Visual Acuity

Grants and funding

study was funded by Alcon Vision LLC, Fort Worth, Texas, USA, the manufacturer of AcrySof IQ PanOptix and AcrySof SN60AT IOLs. JB and CB received consulting fees from Alcon. MD is a full-time employee of Alcon Vision LLC (the study sponsor). HR and RG are employees of Skyward Analytics Pte. Ltd. and Skyward Analytics Pvt. Ltd., respectively, and received consulting fees from Alcon to conduct this study. All authors supported study design, data collection, analysis, and preparation of the manuscript. No authors received remuneration for writing this manuscript. The authors report no other conflicts of interest related to this work.