OBJECTIVES

Cataract surgery is the most frequently performed surgical procedure in the Netherlands and posterior capsule opacification (PCO) is the most common complication post-surgery. Nd:YAG capsulotomy is the standard of care for treating PCO, although it bears a cost and is also associated with complications. PCO development is heavily dependent on the choice of intraocular lens (IOL) for cataract surgery and AcrySof IOLs have consistently demonstrated lower Nd:YAG rates compared to other IOLs, with 1 and 3 year estimates reported as low as 0.6% and 2.4%, respectively. The objective of this research was to estimate annual direct costs associated with the treatment of PCO in the Netherlands.

METHODS

A cost-consequence model was developed comparing healthcare resource utilization and costs associated with PCO. An estimate for the rate of Nd:YAG capsulotomy in the Netherlands was derived from publicaly available statistics (29%), as was estimates for the number of cataract surgeries performed annually (158,415). Cost categories such as associated follow-up consultations (1-per Nd:YAG procedure) and associated (1-year) clinical complications were attained from the published literature. Costs were based on average national tariffs in 2017. Sensitivities of -20% and +20% were applied to PCO associated costs.

RESULTS

For the year 2017, we estimate 45,940 Nd:YAG capsulotomy were procedures performed to treat PCO in the Netherlands. Frequencies of subsequent follow-up consultations (45,940) and cases of clinical complications (RD: 381; CME: 2,733 & Glaucoma: 1,392) were estimated. Total direct costs associated with treating PCO were estimated as being in the region of €12.9 to €19.4 million.

CONCLUSIONS

The total annual direct costs associated with treating PCO in the Netherlands was estimated as being in the region of €12.9 to €19.4 million. The optimal choice of IOL for cataract surgery offers the opportunity to reduce these costs. More research is warranted with respect to indirect costs associated with treating PCO.