@article{Naoum2021-zj,
title = {Cost-Benefit Analysis of Single versus Repeated Use of
Single-Use Devices in Cataract Surgery},
author = {Panagiota Naoum and Sotiria Palioura and Vasiliki Naoum and Nikos Nomikos and Konstantina Bachtalia and Konstantinos Zisis and Kostas Athanasakis and John Kyriopoulos},
year = {2021},
date = {2021-04-01},
journal = {Clin Ophthalmol},
volume = {15},
pages = {1491--1501},
abstract = {PURPOSE: To estimate the net cost effect associated with the
real-world practice of repeated use of designated single-use
medical devices (SUDs) versus their proper single use in cataract
surgery in Greece. DESIGN: A cost-benefit analysis model was
constructed in the form of a decision tree. METHODS: A digital
expert panel was assembled in order to estimate the probabilities
of intraoperative and postoperative complications associated with
single and repeated use of SUDs. Unit costs for the management of
each complication were obtained from the official Greek
bulletins. A Monte Carlo-type sensitivity analysis was performed
to assess the robustness of the results. RESULTS: Based on the
probabilities of complications attained from the expert panel,
repeated use of SUDs is associated with a higher chance of
complications compared to single use, which results in higher
cost of complication management. Under the healthcare sector
perspective, the total expected cost per cataract surgery is
1,403.98€ (1,244.20€ the initial cost of cataract surgery plus
159.78€ the cost of adverse events) in the case of single use,
while for repeated use the total cost is 1,486.29€ (1,146.86€ +
339.43€, respectively) and, thus, repeated use of SUDs in
cataract surgery results in 82.31€ higher expected cost per
patient compared to their single use. Moreover, the societal
perspective analysis indicated even higher additional costs in
the case of SUD reuse (108.24€). CONCLUSION: Repeated use of SUDs
in cataract surgery is not appropriate, it jeopardizes patient
safety and carries a legal liability for the reuser. The present
study, which is the first to attach a monetary value to the
common yet questionable practice of SUD reuse, shows that it is
not cost beneficial. Therefore, it is expected that the results
will have implications in policy formulations to improve the
delivery of cataract healthcare.},
keywords = {SUDs; cataract; cataract surgery; single-use devices},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To estimate the net cost effect associated with the
real-world practice of repeated use of designated single-use
medical devices (SUDs) versus their proper single use in cataract
surgery in Greece. DESIGN: A cost-benefit analysis model was
constructed in the form of a decision tree. METHODS: A digital
expert panel was assembled in order to estimate the probabilities
of intraoperative and postoperative complications associated with
single and repeated use of SUDs. Unit costs for the management of
each complication were obtained from the official Greek
bulletins. A Monte Carlo-type sensitivity analysis was performed
to assess the robustness of the results. RESULTS: Based on the
probabilities of complications attained from the expert panel,
repeated use of SUDs is associated with a higher chance of
complications compared to single use, which results in higher
cost of complication management. Under the healthcare sector
perspective, the total expected cost per cataract surgery is
1,403.98€ (1,244.20€ the initial cost of cataract surgery plus
159.78€ the cost of adverse events) in the case of single use,
while for repeated use the total cost is 1,486.29€ (1,146.86€ +
339.43€, respectively) and, thus, repeated use of SUDs in
cataract surgery results in 82.31€ higher expected cost per
patient compared to their single use. Moreover, the societal
perspective analysis indicated even higher additional costs in
the case of SUD reuse (108.24€). CONCLUSION: Repeated use of SUDs
in cataract surgery is not appropriate, it jeopardizes patient
safety and carries a legal liability for the reuser. The present
study, which is the first to attach a monetary value to the
common yet questionable practice of SUD reuse, shows that it is
not cost beneficial. Therefore, it is expected that the results
will have implications in policy formulations to improve the
delivery of cataract healthcare.