Purpose

To calculate the cost savings associated with a multiuse preoperative and preinjection eyedrop protocol.

Design

Economic analysis.

Participants

Adults undergoing ophthalmic surgical procedures requiring preoperative dilation and intravitreal injections.

Methods

Economic modeling with scenario analysis was used to derive the value for cost savings secondary to a protocol in which perioperative mydriatic eyedrop bottles are used across multiple patients versus the current protocol in which drop bottles are wasted after single-patient use. Similar analyses were performed for a multiuse povidone-iodine protocol for intravitreal injections. Sensitivity analyses were used to test baseline model assumptions with varying degrees of waste and patient volume.

Results

The multiuse mydriatic protocol allowed for a 97.1% reduction in the number of eyedrop bottles required for the single-use protocol (1037 bottles vs. 35 850 bottles). This led to an estimated 5-year cost savings of approximately $240 000 (nominal) per institution (performing an average of 1434 cases/year) in the base case. This savings varied minimally in sensitivity analyses accounting for practical limitations (loss, expiration, or contamination) of multiuse containers, with savings of 97.54% to 95.00% for excess supply ranges from 0% to 100% in the multiuse protocol. Likewise, the cost savings varied minimally in sensitivity analyses for eyedrop sizes, with savings of 99.23% to 96.69% for mydriatic eyedrop sizes of 15 μl per drop to 65 μl per drop, respectively, in the multiuse protocol. Over a 5-year period, for povidone-iodine drops before performing intravitreal injection, the multiuse protocol required 153 bottles compared with 41 954 bottles (99.6% reduction) for the current single-use protocol, resulting in a nominal cost savings of $41 801, which varied minimally in sensitivity analyses.

Conclusions

Multiuse perioperative mydriatic eyedrops are a viable option for cost and environmental waste reduction for ophthalmologic procedures and surgeries requiring dilation. Likewise, multiuse povidone-iodine may allow for large relative cost reduction for in-office procedures. The total potential savings over 5 years was estimated at more than $280 000 before adjusting for inflation.

中文翻译：

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与多用途术前和注射前滴眼液方案相关的潜在成本节约

目的

计算与多用途术前和注射前滴眼液方案相关的成本节约。

设计

经济分析。

参与者

接受需要术前扩张和玻璃体内注射的眼科手术的成人。

方法

使用带有情景分析的经济模型来得出成本节约的价值，该价值是在围手术期散瞳眼药水瓶在多名患者身上使用的方案与当前方案在单个患者使用后浪费滴眼药水的方案中次要的。对玻璃体内注射的多用途聚维酮碘方案进行了类似的分析。敏感性分析用于测试具有不同程度的浪费和患者体积的基线模型假设。

结果

多次使用散瞳方案使一次性方案所需的眼药水瓶数量减少了 97.1%（1037 瓶对 35 850 瓶）。在基本情况下，这导致每个机构（平均每年执行 1434 个案例）估计在 5 年内节省了大约 240 000 美元（名义上的）成本。在考虑到多用途容器的实际限制（丢失、过期或污染）的敏感性分析中，这种节省变化很小，在多用途方案中，过量供应范围从 0% 到 100% 可以节省 97.54% 到 95.00%。同样，在滴眼剂大小的敏感性分析中，成本节约差异很小，在多用途方案中，散瞳滴眼剂大小分别为每滴 15 μl 至每滴 65 μl，可节省 99.23% 至 96.69%。在 5 年的时间里，

结论

多用途围手术期散瞳眼药水是减少眼科手术和需要扩张的手术的成本和环境废物的可行选择。同样，多用聚维酮碘可以大大降低办公室内手术的成本。在调整通货膨胀之前，5 年内的总潜在节省估计超过 280 000 美元。