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Cost-effectiveness of eye care services in Zambia

25 Feb 2014

ObjectiveTo estimate the cost-effectiveness of cataract surgery and refractive error/presbyopia correction in Zambia.
Primary data on costs and health related quality of life were collected in a prospective cohort study of 170 cataract and 113 refractive error/presbyopia patients recruited from three health facilities. Six months later, follow-up data were available from 77 and 41 patients who had received cataract surgery and spectacles, respectively. Costs were determined from patient interviews and micro-costing at the three health facilities. Utility values were gathered by administering the EQ-5D quality of life instrument immediately before and six months after cataract surgery or acquiring spectacles. A probabilistic state-transition model was used to generate cost-effectiveness estimates with uncertainty ranges.
Utility values significantly improved across the patient sample after cataract surgery and acquiring spectacles. Incremental costs per Quality Adjusted Life Years gained were US$ 259 for cataract surgery and US$ 375 for refractive error correction. The probabilities of the incremental cost-effectiveness ratios being below the Zambian gross national income per capita were 95% for both cataract surgery and refractive error correction.
In spite of proven cost-effectiveness, severe health system constraints are likely to hamper scaling up of the interventions.

25 February 2014

Click here to view the full article which appeared in Cost Effectiveness and Resource Allocation