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Review
. 2004:102:177-85; discussion 185-8.

Value-based medicine and ophthalmology: an appraisal of cost-utility analyses

Gary C Brown  1 , Melissa M Brown, Sanjay Sharma, Heidi Brown, Lindsay Smithen, David B Leeser, George Beauchamp
Affiliations
Review

Value-based medicine and ophthalmology: an appraisal of cost-utility analyses

Gary C Brown et al. Trans Am Ophthalmol Soc. 2004.

Abstract

Purpose: To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format.

Methods: Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances.

Results: A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY.

Conclusions: The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.

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Figures

Figure 1
Figure 1
The value-base medicine pyramid. The best evidence-based data are initially converted to value form. This value conferred is then integrated with the associated costs of an intervention to yield a value-based medicine outcome measured in $/QALY, or cost per quality-adjusted life-year gained.
See this image and copyright information in PMC

References

    1. Brown MM, Brown GC, Sharma S, et al. Health care economic analyses and value-based medicine. Surv Ophthalmol. 2003;48:204–223. - PubMed
    1. Sackett DL, Straus SE, Richardson WS, et al. Evidence-Based Medicine. How to Practice and Teach EBM. 2nd ed. Philadelphia: Churchill Livingstone; 2000:1–12.
    1. Sharma S. Levels of evidence. Evid Based Eye Care. 1999;1:5–6.
    1. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA. 1992;268:2420–2425. - PubMed
    1. Brown MM, Brown GC, Sharma S; Quillen DA, ed Value-based medicine. A paradigm for the 21st century. Curr Concepts Ophthalmol. 2002;10:7–11.

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