Cost-Effectiveness of Screening for Open Angle Glaucoma Compared With Opportunistic Case Finding.

Area of Science:

• Ophthalmology
• Health Economics
• Public Health

Background:

• Open-angle glaucoma is a leading cause of blindness, often asymptomatic until advanced stages.
• Current diagnosis relies on opportunistic case finding by optometrists or ophthalmologists.
• Early detection is crucial to prevent vision loss.

Purpose of the Study:

• To assess the cost-effectiveness of a glaucoma screening strategy using optical coherence tomography and fundus photography.
• To compare a systematic screening approach with opportunistic case finding in Spain.

Main Methods:

• A cost-effectiveness analysis comparing screening versus opportunistic finding.
• Utilized a Markov tree model with 10 health states representing disease progression.
• Measured effectiveness using Quality-Adjusted Life Years (QALYs) and included direct health costs.

Main Results:

• The screening program resulted in an increase of 0.097 QALYs at an additional cost of €1187 per patient.
• The incremental cost-effectiveness ratio was approximately €12,214/QALY.
• Sensitivity analyses indicated age and screening program parameters (cost, detection rate) significantly influenced results.

Conclusions:

• The implemented glaucoma screening strategy, incorporating imaging and telemedicine, proved cost-effective in the Spanish setting.
• This approach offers a viable alternative to opportunistic case finding for managing open-angle glaucoma.
• The findings support the integration of systematic screening for early glaucoma detection.