Cost-effectiveness of monitoring ocular hypertension based on a risk prediction tool
Wu, H. 
ORCID: 0000-0001-8377-3276, Gazzard, G. ORCID: 0000-0003-1982-5005, King, A. ORCID: 0000-0002-3091-911X , Morgan, J. ORCID: 0000-0002-8920-1065, Wright, D. ORCID: 0000-0001-8948-3691, Crabb, D. P. ORCID: 0000-0001-8754-3902, Takwoingi, Y. ORCID: 0000-0002-5828-9746, Azuara-Blanco, A. ORCID: 0000-0002-4805-9322, Watson, V. ORCID: 0000-0002-3824-5076 & Hernández, R. ORCID: 0000-0003-2619-8230 (2024).
Cost-effectiveness of monitoring ocular hypertension based on a risk prediction tool.
BMJ Open Ophthalmology, 9(1),
article number e001741.
doi: 10.1136/bmjophth-2024-001741
Abstract
Background/Aims
To assess the cost-effectiveness of making treatment decisions for patients with ocular hypertension (OHT) based on a risk prediction (RP) tool in the United Kingdom.
Methods
A discrete event simulation model was constructed to compare the cost-effectiveness of an alternative care pathway in which the treatment decision was guided by a validated RP tool in secondary care against decision-making based on the standard care (SC). Individual patient sampling was used. Patients diagnosed with OHT and with an intraocular pressure of 24 mm Hg or over entered the model with a set of predefined individual characteristics related to their risk of conversion to glaucoma. These characteristics were retrieved from electronic medical records (n=5740). Different stages of glaucoma were modelled following conversion to glaucoma.
Results
Almost all (99%) patients were treated using the RP strategy, and less than half (47%) of the patients were treated using the SC strategy. The RP strategy produced higher cost but also higher quality-adjusted life years (QALYs) than the SC strategy. The RP strategy was cost-effective compared with the SC strategy in the base-case analysis, with an incremental cost-effectiveness ratio value of £11 522. The RP strategy had a 96% probability of being cost-effective under a £20 000 per QALY threshold.
Conclusions
The use of an RP tool for the management of patients with OHT is likely to be cost-effective. However, the generalisability of the result might be limited due to the high-risk nature of this cohort and the specific RP threshold used in the study.
| Publication Type: | Article |
|---|---|
| Additional Information: | © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. |
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RE Ophthalmology |
| Departments: | School of Health & Psychological Sciences School of Health & Psychological Sciences > Optometry & Visual Sciences |
| SWORD Depositor: |
Available under License Creative Commons: Attribution International Public License 4.0.
Download (799kB) | Preview
Export
Downloads
Downloads per month over past year
Metadata
MetadataActions (login required)
Admin Login