OBJECTIVES: Cataract is one of the most frequently seen eye diseases in Japan. For improving patient’s visual acuity (VA) and quality of life (QoL), more than 1,500,000 cataract surgeries are conducted annually in Japan, accounting for about 85% of all ophthalmic surgeries. Although cost-effectiveness analysis of cataract surgery in Japan has been conducted before (Hiratsuka 2013), we aimed to conduct a cost-effectiveness analysis with claims data to reflect the latest technological development in cataract surgery, and to compare our results with the previous study.

METHODS: A cost-effectiveness analysis, comparing patients with and without receiving cataract surgery, was conducted using a life-time horizon. The perspective of analysis was health care payer. Two cohorts of 70-years old 10,000 patients with or without cataract surgery were assumed respectively. Patients with cataract surgery gained an increase in QoL, which persisted for the rest of their lives; however, QoL of patients without cataract surgery decreased gradually. The health insurance claims data for 2015-2016 from the Japan System Techniques (JAST) database were used to calculate the total costs, including those on surgery and all other medical resources. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER) were calculated as the outcomes.

RESULTS: Compared with patients without cataract surgery, those who received it gained an incremental 2.45 QALYs across their lifetime. The total incremental cost owing to cataract surgery was 137,460 yen. The ICER was found to be 56,106 yen per QALY and lower than that of 163,170 yen per QALY reported previously.

CONCLUSIONS: Our analysis has shown a lower ICER and better effectiveness of cataract surgery than previously reported. Although the surgery fee remains the same as before, the reduction of other relevant medical costs such as hospitalization fees is considered as the main reason for this change, and suggests the latest development in this field.