IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0311158.html
   My bibliography  Save this article

Economic evaluation of an adjunctive intraocular and peri-ocular steroid vitreoretinal surgery for open globe trauma: Cost-effectiveness of the ASCOT randomised controlled trial

Author

Listed:
  • Victory ‘Segun Ezeofor
  • Bethany F Anthony
  • Lucy Bryning
  • Edward J Casswell
  • Suzie Cro
  • Victoria R Cornelius
  • Catey Bunce
  • Elizabeth Robertson
  • Joanna Kelly
  • Caroline Murphy
  • Philip J Banerjee
  • David G Charteris
  • Rhiannon Tudor Edwards

Abstract

Background: In the United Kingdom, it is estimated that 5,000 patients sustain eye injuries or ocular trauma requiring hospital admission annually, of which 250 patients will be permanently blinded. This study explores the cost-effectiveness of Adjunctive Steroid Combination in Ocular Trauma (ASCOT) given during surgery versus standard treatment in vitreoretinal surgery in patients with open globe trauma. Methods: This economic evaluation was embedded alongside the ASCOT RCT (ClinicalTrials.gov Identifier: NCT02873026). We conducted a primary cost-effectiveness analysis from a National Health Service perspective using the proportion of patients who achieved a visual acuity of 10 or more letter improvement on the Early Treatment Diabetic Retinopathy Study (ETDRS) scale as the measure of effect, in developing incremental cost-effectiveness ratios (ICERs). Secondary cost-utility analysis using the EuroQol 5 Dimension 5 Level (EQ-5D-5L) to generate a cost per quality-adjusted life-year (QALY), and a cost-effectiveness analysis using vision-specific quality of life (QoL) was conducted. Sensitivity analyses were also applied to investigate parameter uncertainties. Results: The sample size of the ASCOT intervention arm and standard care arm of this study was 130 and 129, respectively. The intervention cost per patient was estimated at £132. The proportion of participants with an ETDRS of 10 or more letter improvement was 0.47 for the ASCOT group with a mean cost of £5,526 per patient, while the standard care group had an effect of 0.43 with a mean cost of £5,099 per patient. The ICER value of the primary outcome was £12,178 per 10 or more letter improvement on the ETDRS score. The secondary result in terms of cost per QALYs gained had a probability of 44% being cost-effective at a willingness-to-pay threshold of £30,000/QALY gained. Conclusions: Though there is no formally accepted cost-effectiveness willingness-to-pay threshold for 10-letter or more improvement, the ASCOT intervention for open globe trauma is a low-cost intervention. The ASCOT intervention is not cost-effective when compared to the standard care in this group and setting. The proportion of patients in the ASCOT intervention arm with 10 or more letter improvement produced some positive results but this is outweighed by the costs.

Suggested Citation

  • Victory ‘Segun Ezeofor & Bethany F Anthony & Lucy Bryning & Edward J Casswell & Suzie Cro & Victoria R Cornelius & Catey Bunce & Elizabeth Robertson & Joanna Kelly & Caroline Murphy & Philip J Banerje, 2024. "Economic evaluation of an adjunctive intraocular and peri-ocular steroid vitreoretinal surgery for open globe trauma: Cost-effectiveness of the ASCOT randomised controlled trial," PLOS ONE, Public Library of Science, vol. 19(12), pages 1-20, December.
    • Handle: RePEc:plo:pone00:0311158
    DOI: 10.1371/journal.pone.0311158
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0311158
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0311158&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0311158?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Colin H. Ridyard & Dyfrig A. Hughes & DIRUM Team, 2015. "Taxonomy for Methods of Resource Use Measurement," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 372-378, March.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629, Decembrie.
    3. Andrea Manca & Neil Hawkins & Mark J. Sculpher, 2005. "Estimating mean QALYs in trial‐based cost‐effectiveness analysis: the importance of controlling for baseline utility," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 487-496, May.
    4. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Matthew Franklin & James Lomas & Simon Walker & Tracey Young, 2019. "An Educational Review About Using Cost Data for the Purpose of Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 37(5), pages 631-643, May.
    2. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    3. Julie A. Campbell & Glen J. Henson & Valery Fuh Ngwa & Hasnat Ahmad & Bruce V. Taylor & Ingrid Mei & Andrew J. Palmer, 2025. "Estimation of Transition Probabilities from a Large Cohort (> 6000) of Australians Living with Multiple Sclerosis (MS) for Changing Disability Severity Classifications, MS Phenotype, and Disease-Modif," PharmacoEconomics, Springer, vol. 43(2), pages 223-239, February.
    4. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    5. Hossein Haji Ali Afzali & Laura Bojke & Jonathan Karnon, 2018. "Model Structuring for Economic Evaluations of New Health Technologies," PharmacoEconomics, Springer, vol. 36(11), pages 1309-1319, November.
    6. Salah Ghabri & Françoise F. Hamers & Jean Michel Josselin, 2016. "Exploring Uncertainty in Economic Evaluations of Drugs and Medical Devices: Lessons from the First Review of Manufacturers’ Submissions to the French National Authority for Health," PharmacoEconomics, Springer, vol. 34(6), pages 617-624, June.
    7. Yasuhiro Hagiwara & Takeru Shiroiwa, 2022. "Estimating Value-Based Price and Quantifying Uncertainty around It in Health Technology Assessment: Frequentist and Bayesian Approaches," Medical Decision Making, , vol. 42(5), pages 672-683, July.
    8. Amr Makady & Ard Veelen & Páll Jonsson & Owen Moseley & Anne D’Andon & Anthonius Boer & Hans Hillege & Olaf Klungel & Wim Goettsch, 2018. "Using Real-World Data in Health Technology Assessment (HTA) Practice: A Comparative Study of Five HTA Agencies," PharmacoEconomics, Springer, vol. 36(3), pages 359-368, March.
    9. Sara Kaveh & Nashmil Ghadimi & Amirhossein Zarei Alvar & Kamran Roudini & Rajabali Daroudi, 2024. "Trastuzumab plus chemotherapy versus chemotherapy alone in HER2-positive gastric cancer treatment in Iran: a cost-effectiveness analysis," Health Economics Review, Springer, vol. 14(1), pages 1-14, December.
    10. Matthew Franklin & James Lomas & Gerry Richardson, 2020. "Conducting Value for Money Analyses for Non-randomised Interventional Studies Including Service Evaluations: An Educational Review with Recommendations," PharmacoEconomics, Springer, vol. 38(7), pages 665-681, July.
    11. Joseph Kwon & Ruairidh Milne & Clare Rayner & Román Rocha Lawrence & Jordan Mullard & Ghazala Mir & Brendan Delaney & Manoj Sivan & Stavros Petrou, 2024. "Impact of Long COVID on productivity and informal caregiving," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(7), pages 1095-1115, September.
    12. David Brain & Ruth Tulleners & Xing Lee & Qinglu Cheng & Nicholas Graves & Rosana Pacella, 2019. "Cost-effectiveness analysis of an innovative model of care for chronic wounds patients," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-13, March.
    13. Ezeofor Victory & Edwards T. Rhiannon & Burnside Girvan & Adair Pauline & Pine M. Cynthia, 2022. "Cost-effectiveness Analysis of the Dental RECUR Pragmatic Randomized Controlled Trial: Evaluating a Goal-oriented Talking Intervention to Prevent Reoccurrence of Dental Caries in Children," Applied Health Economics and Health Policy, Springer, vol. 20(3), pages 431-445, May.
    14. Astrid Van Muylder & Thomas D’Hooghe & Jeroen Luyten, 2023. "Economic Evaluation of Medically Assisted Reproduction: A Methodological Systematic Review," Medical Decision Making, , vol. 43(7-8), pages 973-991, October.
    15. Sietse Mossel & Rafael Emilio Feria Cardet & Lioe-Fee Geus-Oei & Dennis Vriens & Hendrik Koffijberg & Sopany Saing, 2025. "A Systematic Literature Review of Modelling Approaches to Evaluate the Cost Effectiveness of PET/CT for Therapy Response Monitoring in Oncology," PharmacoEconomics, Springer, vol. 43(2), pages 133-151, February.
    16. Alec Morton & Amanda I. Adler & David Bell & Andrew Briggs & Werner Brouwer & Karl Claxton & Neil Craig & Alastair Fischer & Peter McGregor & Pieter van Baal, 2016. "Unrelated Future Costs and Unrelated Future Benefits: Reflections on NICE Guide to the Methods of Technology Appraisal," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 933-938, August.
    17. Osvaldo Ulises Garay & Marie Libérée Nishimwe & Marwân-al-Qays Bousmah & Asmaa Janah & Pierre-Marie Girard & Geneviève Chêne & Laetitia Moinot & Luis Sagaon-Teyssier & Jean-Luc Meynard & Bruno Spire &, 2019. "Cost-Effectiveness Analysis of Lopinavir/Ritonavir Monotherapy Versus Standard Combination Antiretroviral Therapy in HIV-1 Infected Patients with Viral Suppression in France (ANRS 140 DREAM)," PharmacoEconomics - Open, Springer, vol. 3(4), pages 505-515, December.
    18. Xiao Zang & Emanuel Krebs & Linwei Wang & Brandon D. L. Marshall & Reuben Granich & Bruce R. Schackman & Julio S. G. Montaner & Bohdan Nosyk, 2019. "Structural Design and Data Requirements for Simulation Modelling in HIV/AIDS: A Narrative Review," PharmacoEconomics, Springer, vol. 37(10), pages 1219-1239, October.
    19. Andrija S Grustam & Nasuh Buyukkaramikli & Ron Koymans & Hubertus J M Vrijhoef & Johan L Severens, 2019. "Value of information analysis in telehealth for chronic heart failure management," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-23, June.
    20. Caroline S. Clarke & Mariya Melnychuk & Angus I. G. Ramsay & Cecilia Vindrola-Padros & Claire Levermore & Ravi Barod & Axel Bex & John Hines & Muntzer M. Mughal & Kathy Pritchard-Jones & Maxine Tran &, 2022. "Cost-Utility Analysis of Major System Change in Specialist Cancer Surgery in London, England, Using Linked Patient-Level Electronic Health Records and Difference-in-Differences Analysis," Applied Health Economics and Health Policy, Springer, vol. 20(6), pages 905-917, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0311158. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.