Results and methodology of cost-utility evaluation of cataract surgery in developed countries: Quality-adjusted life years and cataract

This review surveyed the results and methods of cost-utility analyses of cataract surgery. Thirteen studies were included. Based on decision-theoretic time trade-off, utilities ranged from 0.148 to 0.8 and quality-adjusted life years (QALY) ranged from 1.424 to 2.43. Based on psychometric instruments such as Euroqol 5 dimensions, utilities ranged from 0.017 to 0.056 and QALY ranged from 0.141 to 0.547. Reported costs per QALY were between $1307 and $14 302. Although the review found consistent favorable cost QALY ratios for cataract surgery according to the British National Institute for Care and Health Excellence threshold, the findings raise doubts about the general applicability of existing studies as a tool for allocation decision. The observed large heterogeneity of the approaches and outcomes for all parameters reflected the complexity of the various evaluation methods and medical care processes and, in some cases, inadequate data.