Cost Data

The unit costs and outcomes for the resources utilized in the model were obtained from the respective official Greek bulletins. In particular, inpatient and outpatient medication costs were sourced from the Official Medication Price Bulletin published in 2019.¹⁹ Hospitalization cost estimations were based on the official Greek DRG (Diagnosis Related Groups) system, adjusted for wages.^20,21

As far as outpatient visits after cataract surgery are concerned, there is no corresponding official decree determining the cost of the visit for the third-party payer. Therefore, the cost of a doctor’s office visit, in the context of complication management, was calculated on the basis of the fee paid for afternoon clinic visits in public hospitals.²² In addition, the cost of spectacles was sourced from the relevant reimbursement fee paid by the Hellenic National Organization for Health Services Provision (EOPYY).²³ Finally, costs of lost productivity and leisure time were estimated by utilizing the mean daily wage²⁴ and the minimum daily wage²⁵ in Greece, respectively. Cost unit data and outcome analysis refer to 2019 prices in euros (€). Patient transportation cost for physician visits was assumed to be 5.00€.

This cost benefit model was based on the mean of the probabilities derived from the expert panel. As there is uncertainty regarding the validity of these values, a sensitivity analysis using a Monte Carlo-type model was undertaken for the base case scenario (healthcare sector perspective). In this model, simultaneous changes in the values for the probability of each complication are examined through a series of simulations.²⁶ The sensitivity analysis was performed in Excel 2016 software, using the statistical tools included in the software’s add-ons. A total of 10,000 simulations were performed, generating random values based on the Poisson distribution for both single and repeated use of SUDs.