Evidence map›Paper›PMID 39767411›Full record

ArticleInternational journal of environmental research and public health2024

Cost-Effectiveness of Corneal Collagen Crosslinking for Progressive Keratoconus: A Brazilian Unified Health System Perspective.

Lucca Ortolan Hansen, Renato Garcia, André Augusto Miranda Torricelli, Samir Jacob Bechara

Abstract read
In one paragraph

Article in International journal of environmental research and public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Lucca Ortolan HansenDivision of Ophthalmology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil.ORCID 0000-0003-3051-5980
Renato GarciaDivision of Ophthalmology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil.ORCID 0000-0002-2105-7167
André Augusto Miranda TorricelliDivision of Ophthalmology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil.ORCID 0000-0002-3596-1480
Samir Jacob BecharaDivision of Ophthalmology, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Keratoconus is a burden to health systems and patients worldwide. Corneal collagen crosslinking (CXL) treatment has been shown abroad to be cost-effective for treating progressive keratoconus. However, no cost-effectiveness studies have been performed in Brazil. The aim of this study was to assess the cost-effectiveness of corneal collagen crosslinking (CXL) compared with the conventional treatment for progressive keratoconus from the Brazilian Unified Health System (SUS) payer's perspective. A lifetime microsimulation model was utilized to compare the lifetime costs and quality-adjusted life years for patients undergoing corneal collagen CXL or conventional treatment. Two groups of 5000 18-year-old patients were simulated, with one group receiving corneal CXL at the outset and the control group remaining untreated. The TreeAge Pro Healthcare 2024 software was used for modeling and analysis. Corneal collagen CXL demonstrated superior cost-effectiveness compared to the conventional treatment, with an incremental cost-effectiveness ratio of 58.26 USD/quality-adjusted life years (QALY) gained (95% CI: 58.17-58.36) and a positive incremental net monetary benefit of USD 11,613.82 (95% CI: 11,605.66-11,621.99). CXL significantly reduced the number of required corneal transplants, with a mean of 968.8 (95% CI: 959-978.58) fewer transplants per 10,000 eyes treated. The variable with the most significant impact on the incremental net monetary benefit was the duration of the CXL effect. This study concluded that corneal CXL is a highly cost-effective intervention for progressive keratoconus within the Brazilian SUS. These findings advocate for broader accessibility to this vision-saving treatment within the SUS.

Indexed as

CollagenCost-Benefit AnalysisKeratoconusQuality-Adjusted Life YearsAdolescentBrazilCorneaCross-Linking ReagentsHumansMalePhotosensitizing AgentsUltraviolet RaysCollagenCross-Linking ReagentsPhotosensitizing AgentsBrazilian Unified Health Systemcorneal crosslinkingcost-effectivenessincremental cost-effectiveness ratioincremental net monetary benefitkeratoconusquality-adjusted life yearsSUS

Identifiers

PMID39767411
PMCPMC11675724

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.