Abstract

MUSLERA, E.  and  NATAL, C.. Cost-effectiveness of photodynamic therapy in age-related macular degeneration. Arch Soc Esp Oftalmol [online]. 2006, vol.81, n.4, pp.199-204. ISSN 0365-6691.

Objective: The aim of this study was to estimate the public health service cost of visual acuity improvement or maintenance with photodynamic therapy in patients with age-related macular degeneration (ARMD). This illness is the most frequent cause of blindness in elderly patients in western countries. Methods: A cost-effectiveness analysis was carried out to compare photodynamic therapy versus no treatment. The analysis point of view was that of the health service. The improvement or maintenance of visual acuity and contrast sensitivity were considered efficacy results. Direct costs were estimated by means of cost accountancy. Quality adjusted costs per visual acuity life year gained (QACVAG) were calculated through utility values from other studies. Results: The cost per year of maintenance of visual acuity in a two-year period was 36,530 € for women and 34,804 € for men. If this cost was estimated for life expectancy in Asturias, it would be reduced to 4,298 € for women and 5,354 € for men. If costs of the QACVAG, in a two-year period, were considered, photodynamic therapy would cost 66,931 € for women and 70,249 € for men. Conclusion: This cost-effectiveness analysis allows decisions to be made about public financing. Some research in our country suggests that public health financing should be provided for interventions whose cost-effectiveness is less than 30,000 € of CVAQA. The treatment evaluated here far exceeds this value. It is recommended that the use of more restrictive patient selection, incorporating diagnostic criteria and patient autonomy indicators, could improve the results of this intervention.

Keywords : Cost-effectiveness; photodynamic therapy; age-related macular degeneration.

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