Cataract surgery is costly, perhaps not on a case-by-case basis, but when you take the whole country into account, it really adds up. The postoperative drops alone ran the Centers for Medicare and Medicaid Services (CMS) approximately $170 million in 2016. According to researchers out of Baltimore, we can do better.
Investigators explained that, of the 591,733 Medicare beneficiaries who underwent cataract surgery in 2016, 88% were prescribed postoperative drops.
Of those, 57.5% received branded medications, which made up 76.5% of the overall cost.
Of the 43% who only had surgery in one eye, the mean cost of medications was $228. It was $324 for the 57% who had both eyes done. Most patients (89%) were prescribed topical antibiotics. Another 86% used topical steroids and 66% were given nonsteroidal anti-inflammatory drugs. These classes accounted for 26%, 37% and 36%, respectively, of the total cataract surgery eye drop cost.
“Generic alternatives could have resulted in cost savings of as much as $118 million, or 70% of the total cost of postoperative eyedrops,” the study explains. “In the absence of evidence of clinical superiority of expensive vs. less costly options, there is substantial opportunity to improve the value of care delivered to Medicare beneficiaries.”