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Cost-effectiveness of treating ocular hypertension
William C Stewart1, Jeanette A Stewart, Qasiem J Nasser
1PRN Pharmaceutical Research Network, LLC, Charleston, South Carolina, USA. info@prnorb.com
Ophthalmology
|January 2, 2008
Summary
Treating all ocular hypertension (OHT) patients is not cost-effective. However, selective treatment of OHT patients with identified risk factors, such as age and thinner corneas, is cost-effective for preventing glaucoma.
Area of Science:
- Ophthalmology
- Health Economics
Background:
- Ocular hypertension (OHT) is a condition where intraocular pressure is elevated.
- Glaucoma is a progressive optic neuropathy that can lead to vision loss.
Purpose of the Study:
- To assess the cost-effectiveness of treating ocular hypertension (OHT) in the United States.
- To determine if universal treatment of OHT is economically viable compared to selective treatment based on risk factors.
Main Methods:
- A Markov model was utilized for a cost-effectiveness analysis.
- Data on patient health states, practice patterns (Ocular Hypertension Treatment Study - OHTS), and costs were incorporated.
- A 5-year time horizon with a 3% discount rate was applied.
Main Results:
- The incremental cost-effectiveness ratio (ICER) for treating all OHT patients was $89,072.
- Adjusting for OHTS risk factors (age, pressure, corneal thickness, cup-to-disc ratio) yielded lower ICERs, ranging from $35,633 to $46,748.
- Selective treatment based on risk factors demonstrated improved cost-effectiveness.
Conclusions:
- Universal treatment of OHT is not cost-effective.
- Targeted treatment of OHT patients with specific risk factors (advanced age, higher IOP, thinner central corneal thickness, wider vertical cup-to-disc ratio) is a cost-effective strategy.
- This selective approach can prevent glaucomatous damage effectively.
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