Cataract surgeries performed over one year eventually save $123.4 billion over 13 years and delivers a 4,567 percent financial return on investment to society according to the results of a cost-utility study, published online today in the Academy's official journal, Ophthalmology, and will be presented on Nov. 17 at the world's largest ophthalmic conference, the American Academy of Ophthalmology's 117th Annual Meeting, in New Orleans. Researchers say that the results prove that healthcare interventions create substantial economic wealth.
Cataract, which affects approximately 24.5 million Americans, is a condition in which the eye's lens becomes cloudy and can lead to blindness if not treated through surgery. Cataract surgery is the most common, major ophthalmic surgical procedure. Researchers from the Center for Value-Based Medicineฎ used data from the National Study of Cataract Outcomes. They measured both the direct and indirect costs associated with vision loss due to cataract and compared these costs to the value of cataract surgery in 2012. They also compared their findings to similar studies that were also conducted using the National Study of Cataract Outcomes in both 2000 and 1985.
The majority of the $123.4 billion savings are in patient cost savings and Medicare savings, which accounted for 39.4 percent 29.5 percent, respectively. Other gains included employment/productivity (20.6 percent), Medicaid (2.7 percent) and other insurers (7.8 percent). This means that for each cataract surgery on a single eye, which costs an average of $2,653, the savings will amount to $121,198. Additionally, the researchers found that over the 13-year model, cataract surgery yielded a 4,567 percent financial return on investment to society.
When compared to the estimated costs in previous study years, it was found that the overall cataract surgery cost in 2012 was 34.4 percent less expensive than in 2000 and 85 percent less expensive than in 1985 after adjusting for inflation. Furthermore, the inflation-adjusted physician fee in 2012 was only 10.1 percent of what it had been in 1985.
In terms of the patient value, the researchers found that cataract surgery yields an overall 36.2 percent gain in quality-of-life when performed in both eyes. Without cataract surgery, cataract-related vision loss can become so bad that individuals lose their independence in a variety of ways, such as being able to drive, read their mail, keep up their home and administer their medications.
"Most people regard healthcare costs, which are estimated by the Centers for Medicare and Medicaid at $2.81 trillion in 2012, as expenditures and not investment dollars that return patient value and financial value," said lead researcher Melissa M. Brown, M.D., of the Center for Value-Based Medicine and Wills Eye Hospital. "Our data demonstrates that this approach is far too simplistic and that estimating the return on investment provides a more complete picture. Cataract surgery is a paradigm for the premise that healthcare interventions, in addition to creating substantial patient value, can also create considerable economic wealth."
The study, The Extraordinary Patient Value and Financial Value to Society Conferred by Cataract Surgery (PA022) will be presented on Nov. 17 at the 117th Annual Meeting of the American Academy of Ophthalmology, which is in session November 16-19 at Ernest N. Morial Convention Center in New Orleans.
- Gary C. Brown, Melissa M. Brown, Alicia Menezes, Brandon G. Busbee, Heidi B. Lieske, Philip A. Lieske. Cataract Surgery Cost Utility Revisited in 2012. Ophthalmology, 2013; 120 (12): 2367 DOI: 10.1016/j.ophtha.2013.04.030
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