Economic Evaluation of ASCOT Trial for Eye Trauma
Background
In the UK, around 5,000 people suffer eye injuries each year, with 250 resulting in permanent blindness. This study looks at the cost-effectiveness of using an adjunctive steroid treatment during surgery for patients with open globe trauma compared to standard treatment.
Methods
This evaluation was part of the ASCOT randomized controlled trial (ClinicalTrials.gov Identifier: NCT02873026). We analyzed costs from the National Health Service’s perspective, focusing on patients who improved their vision significantly. We also assessed quality of life and conducted sensitivity analyses to address uncertainties.
Results
The study included 130 patients in the ASCOT group and 129 in the standard care group. The cost for the ASCOT treatment was about £132 per patient. In the ASCOT group, 47% showed significant vision improvement, costing £5,526 per patient, while the standard care group had a 43% improvement at £5,099 per patient. The incremental cost-effectiveness ratio (ICER) was £12,178 for each significant vision improvement. The secondary analysis showed a 44% chance of being cost-effective at a threshold of £30,000 per quality-adjusted life year (QALY).
Conclusions
While the ASCOT intervention is low-cost, it is not considered cost-effective compared to standard care in this context. The positive outcomes in vision improvement do not justify the additional costs incurred.
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