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Ophthalmology AdvisorNo Reimbursements for Femtosecond Cataract Surgery, Trial Recommends

Is the commonly used Femtosecond laser-assisted cataract surgery worth the cost compared to the more cost-effective phacoemulsification cataract surgery?


The results of a study published in JAMA Ophthalmology show a stark contrast between the cost-effectiveness of Femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification cataract surgery (PCS).

Key Points:
  • The research conducted a secondary analysis of the FEMCAT trial, focusing on cost utility between FLACS and PCS.
  • Study comprised of 870 participants, majority of whom were women with an average age of 72.3 years.
  • Mean costs for cataract surgeries were $1235 for FLACS and $621 for PCS.
  • Total mean cost of care at 12 months: $7787 for FLACS patients and $7146 for PCS patients.
  • FLACS resulted in a mean of 0.788 QALYs and PCS yielded 0.792 QALYs.
  • ICER for FLACS was $150,000 per QALY.
Additional Points:
  • Femtosecond cataract surgery’s cost-effectiveness probability compared with PCS stood at 15.7% at a threshold of $32,973 per QALY.
  • The EVPI at this threshold was $270,530,231.
  • FACT trial’s cost-utility analysis reported a small cost difference between PCS and FLACS, supporting these results.
  • Limitations of the study include small sample size and limitation of information analysis to the calculation of EVPI.
Conclusion:
  • The study concludes that FLACS is not cost-effective compared to PCS and should not be reimbursed by healthcare systems.

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“All these results are very consistent, with outcomes of FLACS and PCS very close to each other and always to the disadvantage of FLACS. This is a sign of robustness of our results.”

Study Authors
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