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Abstract #21097 Published in IGR 10-2
Economic evaluation of screening for open-angle glaucoma
Hernandez RA; Burr JM; Vale LDInternational Journal of Technology Assessment in Health Care 2008; 24: 203-211
See also comment(s) by Steve Kymes •
OBJECTIVES: The aim of this study was to assess the cost-effectiveness of screening for open-angle glaucoma (OAG) in the United Kingdom, given that OAG is an important cause of blindness worldwide. METHODS: A Markov model was developed to estimate lifetime costs and benefits of a cohort of patients facing, alternatively, screening or current opportunistic case finding strategies. Strategies, varying in how screening would be organized (e.g., invitation for assessment by a glaucoma-trained optometrist [GO] or for simple test assessment by a technician) were developed, and allowed for the progression of OAG and treatment effects. Data inputs were obtained from systematic reviews. Deterministic and probabilistic sensitivity analyses were performed. RESULTS: Screening was more likely to be cost-effective as prevalence increased, for 40 year olds compared with 60 or 75 year olds, when the re-screening interval was greater (10 years), and for the technician strategy compared with the GO strategy. For each age cohort and at prevalence levels of ≤ 1%, the likelihood that either screening strategy would be more cost-effective than current practice was small. For those 40 years of age, 'technician screening'compared with current practice has an incremental cost-effectiveness ratio (ICER) that society might be willing to pay when prevalence is 6% to 10% and at over 10% for 60-year olds. In the United Kingdom, the age specific prevalence of OAG is much lower. Screening by GO, at any age or prevalence level, was not associated with an ICER < £30,000. CONCLUSIONS: Population screening for OAG is unlikely to be cost-effective, but could be for specific subgroups at higher risk.
Dr. R.A. Hernandez. University of Aberdeen, UK. R.a.hernandez@abdn.ac.uk
Classification:
14 Costing studies; pharmacoeconomics
1.6 Prevention and screening (Part of: 1 General aspects)