Cost effectiveness of collagen crosslinking for progressive keratoconus in the UK NHS

Eye
H A SalmonN A Frost

Abstract

Keratoconus is a progressive degenerative corneal disorder of children and young adults that is traditionally managed by refractive error correction, with corneal transplantation reserved for the most severe cases. UVA collagen crosslinking is a novel procedure that aims to prevent disease progression, currently being considered for use in the UK NHS. We assess whether it might be a cost-effective alternative to standard management for patients with progressive keratoconus. We constructed a Markov model in which we estimated disease progression from prospective follow-up studies, derived costs derived from the NHS National Tariff, and calculated utilities from linear regression models of visual acuity in the better-seeing eye. We performed deterministic and probabilistic sensitivity analyses to assess the impact of possible variations in the model parameters. Collagen crosslinking is cost effective compared with standard management at an incremental cost of £ 3174 per QALY in the base case. Deterministic sensitivity analysis shows that this could rise above £ 33,263 per QALY if the duration of treatment efficacy is limited to 5 years. Other model parameters are not decision significant. Collagen crosslinking is cost effective i...Continue Reading

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Citations

May 11, 2016·Journal of Refractive Surgery·Daniel A GodefrooijRobert P L Wisse
Mar 31, 2018·Cornea·Claudia Perez-StraziotaYaron S Rabinowitz
Dec 17, 2015·Monash Bioethics Review·Benjamin Capps
Nov 11, 2019·Journal of Cataract and Refractive Surgery·Kenneth A BeckmanUNKNOWN ASCRS Cornea Clinical Committee
Feb 28, 2019·Computational Intelligence and Neuroscience·Alexandru Lavric, Popa Valentin
May 10, 2017·Journal of Refractive Surgery·Myriam CassagneFrançois Malecaze
Nov 20, 2020·Journal of Medical Economics·Richard L LindstromJohn A Carter
May 26, 2020·Contact Lens & Anterior Eye : the Journal of the British Contact Lens Association·Elke O KrepsCarina Koppen
Aug 14, 2021·Clinical & Experimental Optometry : Journal of the Australian Optometrical Association·Devanshi JaniStuti L Misra

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