OBJECTIVES: AcrySof IQ Vivity is the first and only Extended Depth of Focus (EDoF) intraocular lens (IOL) with the Wavefront-Shaping X-WAVE technology and a clinically proven monofocal visual disturbance profile. This study estimates the cost-effectiveness of AcrySof IQ Vivity IOL vs. standard aspheric monofocal IOL, from a private health fund perspective in Australia.

METHODS: A Markov model was developed using the following health states: well, need for spectacles (near/distance/multifocal), severe visual disturbances – with/without spectacles, and death. Model inputs were sourced from a randomized clinical study (NCT03010254), published literature, and expert opinion. IOL costs (AcrySof IQ Vivity-AU$651, and AcrySof SN60WF- AU$290) were derived from the published prostheses list. A lifetime time horizon (30 years) was considered, and cost and health outcomes were discounted at 5% per annum. Model outcomes included incremental cost-effectiveness ratio (ICER) per quality adjusted life year (QALY) gain. Sensitivity and scenario analyses were also conducted.

RESULTS: Bilateral implantation of AcrySof IQ Vivity IOL provided QALY gain of 0.16 at an incremental lifetime cost of AU$384 vs. monofocal IOL leading to ICER of AU$2,383/QALY, which is well below the cost-effectiveness thresholds (Range: AU$45,000-AU$75,000) typically used by Medical Services Advisory Committee Australia. Results were sensitive to the cost of IOL prosthesis, post-operative spectacle dependence, and disutility due to wearing glasses. The robustness of results was further confirmed by probabilistic sensitivity analysis, and scenario analyses.

CONCLUSIONS: AcrySof IQ Vivity IOL is a highly cost-effective treatment strategy with improved vision-related quality of life outcomes for patients undergoing cataract surgery.