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Related Experiment Videos

Cost effectiveness of screening for primary open angle glaucoma

J F Boivin1, M McGregor, C Archer

  • 1Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Canada.

Journal of Medical Screening
|January 1, 1996
PubMed
Summary

Glaucoma screening programs are not cost-effective, even with 50% treatment efficacy. Targeted screening in older adults (65-79) is more efficient but still limited in preventing blindness.

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Area of Science:

  • Ophthalmology
  • Public Health
  • Health Economics

Background:

  • Glaucoma is a leading cause of irreversible blindness worldwide.
  • Early detection through screening is crucial for managing glaucoma and preventing vision loss.
  • The cost-effectiveness of various glaucoma screening strategies remains an important public health consideration.

Purpose of the Study:

  • To evaluate the cost-effectiveness of different glaucoma screening strategies.
  • To determine the optimal screening frequency, age groups, and diagnostic methods for glaucoma detection.

Main Methods:

  • A literature review and analysis of administrative databases were conducted to gather data on treatment efficacy, diagnostic methods, glaucoma epidemiology, and costs.
  • Multiple screening scenarios were modeled, varying screening frequency, participant age, screening participation rates, treatment compliance, treatment efficacy, and diagnostic tests.

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Main Results:

  • A three-yearly screening of individuals aged 40-79 using funduscopy and tonometry, with perimetry for abnormalities, cost $C100,000 per year of blindness prevented (assuming 75% participation and 50% treatment efficacy).
  • Restricting screening to ages 65-79 reduced costs to $C42,000 per year of blindness prevented, preventing 81% of cases.
  • Tonometry-only screening in ages 65-79 cost $C36,000 per year of blindness prevented but only prevented 59% of cases.

Conclusions:

  • Current evidence does not definitively prove that treating glaucoma or high intraocular pressure can halt its progression to blindness.
  • Even with a high assumed treatment efficacy of 50%, most evaluated glaucoma screening programs are not cost-effective.
  • Targeted screening in older populations (65-79) offers improved cost-effectiveness but with limitations in overall blindness prevention.