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Cost-effectiveness of 2 Approaches to Managing Nasolacrimal Duct Obstruction in Infants

Cost-effectiveness of 2 Approaches to Managing Nasolacrimal Duct Obstruction in Infants CLINICAL SCIENCES JOURNAL CLUB Cost-effectiveness of 2 Approaches to Managing Nasolacrimal Duct Obstruction in Infants The Importance of the Spontaneous Resolution Rate Kevin D. Frick, PhD; Luxme Hariharan, MD, MPH; Michael X. Repka, MD, MBA; Danielle Chandler, MSPH; B. Michele Melia, ScM; Roy W. Beck, MD, PhD; for the Pediatric Eye Disease Investigator Group (PEDIG) Objective: To assess the impact of the rate of sponta- Results: Under the base case, assuming a 75% spontane- neous resolution of congenital nasolacrimal duct ob- ous resolution rate during 6 months prior to deferred prob- struction on the relative cost-effectiveness of deferred na- ing, IOPS is more expensive ($771 vs $641) and slightly solacrimal duct probing in a surgical facility (DFPS) less effective (93.0% vs 97.5%) than DFPS, although IOPS compared with an immediate office-based probing sur- costs only $44 per month of symptoms avoided. At spon- gery (IOPS). taneous resolution rates between 50% and 68%, IOPS costs less than DFPS (from $2 to $342 less), although it also is Methods: Data from the literature, Medicare 2009 fee slightly less effective (from 2.0% to 3.8% less). At a 90% schedule, and consensus assumptions were combined to spontaneous resolution rate, IOPS costs $169 per http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Ophthalmology American Medical Association

Cost-effectiveness of 2 Approaches to Managing Nasolacrimal Duct Obstruction in Infants

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Publisher
American Medical Association
Copyright
Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6165
eISSN
2168-6173
DOI
10.1001/archophthalmol.2011.80
pmid
21555614
Publisher site
See Article on Publisher Site

Abstract

CLINICAL SCIENCES JOURNAL CLUB Cost-effectiveness of 2 Approaches to Managing Nasolacrimal Duct Obstruction in Infants The Importance of the Spontaneous Resolution Rate Kevin D. Frick, PhD; Luxme Hariharan, MD, MPH; Michael X. Repka, MD, MBA; Danielle Chandler, MSPH; B. Michele Melia, ScM; Roy W. Beck, MD, PhD; for the Pediatric Eye Disease Investigator Group (PEDIG) Objective: To assess the impact of the rate of sponta- Results: Under the base case, assuming a 75% spontane- neous resolution of congenital nasolacrimal duct ob- ous resolution rate during 6 months prior to deferred prob- struction on the relative cost-effectiveness of deferred na- ing, IOPS is more expensive ($771 vs $641) and slightly solacrimal duct probing in a surgical facility (DFPS) less effective (93.0% vs 97.5%) than DFPS, although IOPS compared with an immediate office-based probing sur- costs only $44 per month of symptoms avoided. At spon- gery (IOPS). taneous resolution rates between 50% and 68%, IOPS costs less than DFPS (from $2 to $342 less), although it also is Methods: Data from the literature, Medicare 2009 fee slightly less effective (from 2.0% to 3.8% less). At a 90% schedule, and consensus assumptions were combined to spontaneous resolution rate, IOPS costs $169 per

Journal

JAMA OphthalmologyAmerican Medical Association

Published: May 1, 2011

References