Cost-Effectiveness of Photobiomodulation for Intermediate Dry Age-Related Macular Degeneration: A Model-Based Analysis Using the LIGHTSITE III 24-Month Trial
Watane A, Witkin A, Heier J, Shah C
American journal of ophthalmology · 0 citas
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2026-07-25 · Am J Ophthalmol · vol. 291 · págs. 324–333
- Editorial
- Elsevier BV
- Citado
- 1 cita · más que el 97% de estudios similares · 7.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 15 trabajos
- Acceso
- De pago
- Áreas de investigación
- Health Systems, Economic Evaluations, Quality of Life · Retinal Diseases and Treatments · Retinal Imaging and Analysis
- Palabras clave
- low-level laser therapy, cost-effectiveness, geographic atrophy, Markov model, budget impact, quality-adjusted life years, visual acuity, treatment uptake, willingness-to-pay threshold, EQ-5D
- MeSH
- humans, markov chains, visual acuity, quality-adjusted life years, quality of life, aged, cost-benefit analysis, health care costs, united states, female, male, geographic atrophy, low-level light therapy, cost-effectiveness analysis
4 autores
- Arjun Watane🇺🇸 · autor de correspondenciaTufts University; Ophthalmic Consultants of Boston
- André J. Witkin🇺🇸Tufts University; Ophthalmic Consultants of Boston
- Jeffrey Heier🇺🇸Ophthalmic Consultants of Boston
- Chirag P. Shah🇺🇸Ophthalmic Consultants of Boston
Resumen
El texto original del estudio, en el idioma en que se publicó.
Purpose
To evaluate the cost-effectiveness of photobiomodulation (PBM) for intermediate dry age-related macular degeneration (AMD) from the US healthcare payer perspective, using 24-month LIGHTSITE III trial data.
Design
Model-based cost-effectiveness analysis using a 5-state Markov model with 6-month cycles over a 10-year horizon, discounting costs and outcomes at 3% annually.
Participants
Modeled cohort of adults with bilateral intermediate dry AMD and best-corrected visual acuity (BCVA) 20/32-20/100, consistent with LIGHTSITE III eligibility.
Methods
Transition probabilities were derived from LIGHTSITE III 24-month outcomes and AREDS natural history data. Costs were derived from 2025 Medicare Physician Fee Schedule and published claims-based sources. One-way and probabilistic sensitivity analyses, a societal perspective, a 2-year limited treatment scenario, and a 5-year national budget impact analysis were conducted.
Main outcome measures
Quality-adjusted life-years (QALYs) derived from published visual acuity-to-utility mapping and VFQ-25-to-EQ-5D conversion of LIGHTSITE III quality-of-life data; incremental cost-effectiveness ratio (ICER) as cost per QALY; 5-year national budget impact.
Results
PBM yielded 5.244 discounted QALYs at an incremental cost of $29,556 over 10 years, producing a base-case ICER of $73,910 per QALY, below both the $100,000 and $150,000 US willingness-to-pay thresholds. The ICER ranged from $36,700 ($1,000/course) to $117,694 per QALY (30% geographic atrophy [GA] reduction) across clinically realistic scenarios. Only the $5,000/course scenario exceeded both thresholds. The 5-year cumulative national budget impact was $25.0 billion at 20% uptake.
Conclusions
PBM is cost-effective at conventional US willingness-to-pay thresholds, driven primarily by a 71.7% relative reduction in incident GA at 24 months. These findings support coverage consideration of PBM for intermediate dry AMD, pending independent replication of the GA reduction and prospective EQ-5D data collection.
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