Barták, M.; Kruntorádová, I.; Lamblová, K.; Rogalewicz, V.
Central European Conference in Finance and Economics (CEFE2017). Košice: Technická univerzita v Košiciach, Ekonomická fakulta, 2017. pp. 70-79. ISBN 978-80-553-2906-2
The goal is to quantify direct costs related to different types of implanted intraocular lenses from the perspective of public health insurance and from the patient´s perspective. The calculations were carried out based on three scenarios. The first scenario describes the real current situation, when the health insurance company reimburses the performances related to the senile cataract treatment including a monofocal artificial intraocular lens (IOL), and the patient pays for all the materials in the case he/she requires a multifocal or toric IOL. The second scenario analyses the situation, when there was the category of so-called “nadstandard” in the Czech healthcare system. In this case, the health insurance company reimburses the performances related to the senile cataract treatment including the sum equivalent to the price of a monofocal IOL as the cheapest option. The patient pays the price difference between the implanted toric or multifocal lens and an equivalent monofocal lens. The third scenario describes the situation corresponding to the judicial interpretation, when the health insurance company reimburses only the performances related to the senile cataract treatment including a monofocal IOL, and if a patient requires a multifocal or toric IOL, he/she pays for the whole operation including the materials himself/herself. The study covered a cohort of 200 patients in the age of 65+ treated at 4 cataract surgery performing clinics in 2014. Direct costs of the surgery from the public health insurance perspective were CZK 24,900 per person (one eye). Patient´s direct costs were lower for monofocal lenses than for multifocal ones. Patients’ costs for an IOL and the related treatment reached up to CZK 35,000, out of pocket expenses after the treatment averaged out at CZK 4,450. The monofocal IOL appears to be the best option from the point of view of cost effectiveness both from the perspective of public health insurance and from the patient´s perspective.