Modelling lifetime cost consequences of ReSTOR(® )in cataract surgery in four European countries

BACKGROUND: To compare the lifetime costs of liberating patients from spectacles after cataract surgery by implanting the multifocal intraocular lens (IOL) 'ReSTOR(®)' versus monofocal IOLs in France, Italy, Germany and Spain. METHODS: A Markov model was created to follow patient cohorts from cataract surgery until death. Prevalence rates of patients not needing spectacles after cataract surgery were obtained from clinical trials. Resource utilisation included implant surgery, IOLs, spectacles, visits to ophthalmologists and eye centres, transport, and time lost by patients. Economic perspectives were those of Society and Sickness Funds (SFs). RESULTS: The mean number of spectacles purchased after ReSTOR(® )was 1.34–1.61 and after monofocal IOLs 6.05–7.27. From the societal perspective, total cost estimates discounted by 3% were between €3,551 and €4,052 with ReSTOR(® )compared to €3,989 and €5,548 with monofocal IOLs. Undiscounted savings related to ReSTOR(®) ranged from €815 to €2,164. From the SFs' perspective total cost estimates discounted by 3% were between €2,150 and €2,524 with ReSTOR(® )compared to €2,324 and €2,610 with monofocal IOLs. Savings related to ReSTOR(®), once costs discounted, ranged from €61 to €219. Discount and spectacle freedom prevalence rates were the most sensitive parameters. CONCLUSION: The bulk of the savings related to ReSTOR(®) were realized outside the SF. From both a societal and SF perspective, savings, after a 3% discounting, achieved by liberating patients from spectacles counterbalanced the initially higher cost of ReSTOR(®). ReSTOR(® )is a cost saving alternative to spectacles for patients requiring cataract surgery.