Cost-benefit analysis of a trifocal intraocular lens versus a monofocal intraocular lens in South Korea

This study aimed to estimate the net monetary benefit (NMB) of trifocal intraocular lenses (IOL) versus monofocal IOL in South Korea according to patient age. A hybrid model with a short-term decision tree, followed by a lifetime Markov model, was developed. The study considered patients aged 45-75 years old. Probabilities of visual disturbances and wearing glass were obtained from a clinical trial of trifocal IOL (NCT03280108). The analysis considered medical and glass costs. Utility values for each age were adopted from previous studies. The incremental QALY was mapped to the patient's willingness to pay (WTP) thresholds of gross domestic product per capita (GDP; $32,310), $23,000, and $15,000 per QALY gain to estimate the NMB. Trifocal IOL incurred higher costs but resulted in increased QALYs in all age groups. Under the WTP of $15,000, the NMB ranged from $694 at 75 to $6,880 at 45. The NMB with GDP was from $6,731 at 75 to $19,590 at 45. Using trifocal IOL can enhance the quality of life compared to no presbyopia correction with monofocal IOL in patients who want to correct presbyopia. Younger patients have greater economic benefits. Thus, trifocal IOLs are a worthy treatment option considering age and WTP.