A Cost-Effectiveness Analysis of AcrySof IQ Vivity Intraocular Lens (IOL) from Private Health Fund Perspective in Australia

Chandra Bala,1 Paul Athanasiov,2 Jason Holland,3 Mukesh Dhariwal,4 Amit Gupta,5 Hemant Rathi6 1personalEYES Pty Ltd, Sydney, NSW, Australia; 2Eye Surgeons SA, North Adelaide, SA, Australia; 3The Eye Health Centre, Brisbane, QLD, Australia; 4Alcon Vision LLC, Fort Worth, TX, USA; 5Skyward Analytics Pvt Ltd, Gurgaon, India; 6Skyward Analytics Pte Ltd, SingaporeCorrespondence: Chandra Bala, personalEYES Pty Ltd, Level 2, 33 York Street, Sydney, NSW, 2000, Australia, Tel +61-2-88337111, Fax +61-2-88337112, Email Bala@personaleyes.com.auPurpose: AcrySof IQ Vivity is a unique non-diffractive extended depth of focus intraocular lens with wavefront-shaping X-WAVE technology. This study evaluated the cost-effectiveness of AcrySof IQ Vivity intraocular lens (DFT015) compared with standard aspheric monofocal intraocular lens (SN60WF), from a private health fund perspective in Australia.Methods: A Markov model was developed using the following health states: well, need for spectacles (near/distance/bifocal/varifocal), very bothersome visual disturbances (glare/haloes/starbursts) – with/without spectacles, and death. Model inputs were sourced from a randomized clinical study (NCT03010254), published literature, prostheses list and clinical opinion. A lifetime horizon (up to 30 years) was considered, and cost and health outcomes were discounted at 5% per annum. Model outcomes included incremental cost–effectiveness ratio defined as incremental cost per quality adjusted life year gain. Sensitivity and scenario analyses were also conducted.Results: Bilateral implantation of DFT015 intraocular lens provided quality adjusted life year gain of 0.16 at an incremental cost of AU$307 compared to bilateral SN60WF, leading to an incremental cost-effectiveness ratio of AU$1908/quality adjusted life year, well below the cost-effectiveness threshold (Range: AU$45,000-AU$75,000) typically used by Medical Services Advisory Committee in Australia. Results were most sensitive to intraocular lens costs, post-operative spectacle dependence, and disutility due to wearing glasses. Robustness of the results was further confirmed by probabilistic sensitivity analysis and scenario analyses.Conclusion: AcrySof IQ Vivity intraocular lens is a highly cost-effective treatment strategy with improved vision-related quality of life outcomes for presbyopic cataract surgery patients.Keywords: cataract surgery, ATIOL, EDoF, presbyopia, ICER, quality of life