Cost-utility analysis of screening and laser treatment of retinopathy of prematurity

Purpose: Retinopathy of prematurity (ROP) is a major cause of lifelong blindness beginning in infancy. Utility analysis is used to describe the effect of illness and medical intervention on an individual's quality of life during the course of a lifetime. In this study, cost-utility analysis is used to evaluate the cost-effectiveness of both screening and laser photoablation for ROP. Methods: Data from 2 neonatal intensive care units were recorded for infants screened and treated for ROP between March 4, 2004, and January 5, 2006. The cost model was developed using procedures classified by Current Procedural Terminology and the costs paid for by the Centers for Medicare and Medicaid Services for 2006. Visual acuities were obtained from 10-year post-laser data and from the 10-year post-CRYO-ROP untreated cohort. Results: During the study period, 515 infants received screening and treatment for ROP. They required a mean 3.4 exams per infant; 11.2% received laser photoablation. Mean visual acuities were 0.5 (Snellen 20/40) for laser-treated eyes and 0.20 (Snellen 20/100) for those who did not receive treatment. The cost-effectiveness of screening and laser photoablation of ROP in 2006 is $650/quality-adjusted life years. When discounted 3% per year for the time value of money, the cost is $1,565/ quality-adjusted life years. Conclusions: The screening and laser photoablation of ROP continue to be extremely cost-effective medical interventions. © 2009 American Association for Pediatric Ophthalmology and Strabismus.