Cost-utility Analysis of Rhegmatogenous Retinal Detachment Surgery

Objective To perform a cost-utility analysis of rhegmatogenous retinal detachment （RRD） surgery. Methods Data of 117 patients who underwent RRD surgeries were collected in Shanghai First People＇s Hospital, Affiliated Shanghai Jiaotong University, and were followed up for at least one year. Costs associated with surgery were recorded. Utility values of RRD surgery were obtained by using time trade-off （TTO） method, and quality-adjusted life years （QALYs） were calculated using the patients’ life expectancy at 3% discounted rate. Incremental cost-utility analysis was performed （as compared to no treatment） by calculating incremental cost-effectiveness ratio （ICER）, which means the mean incremental cost for each QALY. Bootstrap method was used to make statistical analysis, and one-way sensitivity analyses were performed to test robustness of the results. Results Mean incremental cost of RRD surgery was RMB 8 471 yuan 95% confidence interval（CI） 7 716~9 227 yuan, mean additional QALY gained was 1.24 （95%CI 0.73~1.76）, and the incremental cost for each additional QALY was RMB 6 819 yuan （95%CI 4 711~11 816 yuan）, among which, for scleral buckling surgery, the incremental cost for each additional QALY was RMB 4 892 yuan （95%CI 3 366~8 971 yuan）, and for vitreous surgery, the incremental cost for each additional QALY was RMB 17 134 yuan （95%CI 8 824~73 110 yuan）. Conclusion For RRD patients, the surgery does help them obtain more quality-adjusted life years, and the incremental costs for each QALY gained are 6 819 yuan.