Windsor, M.A., SJJ, S., Frick, K.D., Swanson, E.A., Rosenfeld, P.J., Huang, D.
期刊名称：American journal of ophthalmology
层析 光学 血管
摘要：目的：旨在比较使用光学相干断层扫描（OCT）指导新生血管性年龄相关性黄斑变性（nvAMD）治疗的患者和医保费用，为美国国立卫生研究院（NIH）和美国国立卫生研究院 基金会（NSF）研发OCT制定科研投资提供数据。设计：观察性队列研究。方法：主要观察指标是医疗保险支出，如现行操作术语玻璃体内注射（67028），视网膜OCT显像（92134）和抗血管内皮生长因子（抗VEGF）治疗特异性J （J0178，J2778，J9035，J3490和J3590）。这些数据来自2012年至2015年的医保和服务费（FFS）医保受益人中心的医疗保险提供者利用和支付数据; 2008年的数据是从100％FFS B部分医疗保险索赔档案中获得的。 OCT的研究成本通过从开始到2015年NIH和NSF颁发的补助来确定的。所有的费用都以每年3％进行折现，并将通货膨胀调整到2015美元。结果：2008年至2015年，美国政府和nvAMD患者使用OCT指导个性化抗VEGF治疗分别节省了90亿美元和22亿美元。 90亿美元代表政府对通过NIH和NSF资助开发技术投资回报率的21倍。结论：虽然政府资助的研究的整体成本效益比很难估计，因为收益可能弥漫和延迟， 20多年来的OCT投资已经通过更好的个性化治疗在短短几年内得到了多次回报。
PURPOSE:To compare patient and Medicare savings from the use of optical coherence tomography (OCT) in guiding therapy for neovascular age-related macular degeneration (nvAMD) to the research investments made in developing OCT by the National Institutes of Health (NIH) and the National Science Foundation (NSF).DESIGN:Observational cohort study.METHODS:Main outcome measures were spending by Medicare as tracked by Current Procedural Terminology codes on intravitreal injections (67028), retinal OCT imaging (92134), and anti-vascular endothelial growth factor (anti-VEGF) treatment-specific J-codes (J0178, J2778, J9035, J3490, and J3590). These claims were identified from the Medicare Provider Utilization and Payment Data from the Centers for Medicare and Medicaid Services among fee-for-service (FFS) Medicare beneficiaries from 2012 to 2015; 2008 claims were acquired from the 100% FFS Part B Medicare Claims File. OCT research costs were determined by searching for grants awarded by NIH and NSF from inception to 2015. All costs and savings were discounted by 3% annually and adjusted for inflation to 2015 dollars.RESULTS:From 2008 to 2015, the United States government and nvAMD patients have accrued an estimated savings of $9.0 billion and $2.2 billion, respectively, from the use of OCT to guide personalized anti-VEGF treatment. The $9.0 billion represents a 21-fold return on government investment into developing the technology through NIH and NSF grants.CONCLUSIONS:Although an overall cost-benefit ratio of government-sponsored research is difficult to estimate because the benefit may be diffuse and delayed, the investment in OCT over 2 decades has been recouped many times over in just a few years through better personalized therapy.