COST-EFFECTIVENESS OF REGULAR COMPREHENSIVE EYE EXAMINATIONS FOR A COMMUNITY DWELLING OLDER POPULATION: PRELIMINARY RESULTS
Author(s)
Mengke Yu, MS1, Tina Jinxiao Lian, PhD1, Ching So, BSc1, Sarah Morag McGhee, PhD2, Wing Man Sum, DHSc1, Keng Hung Yap, PhD1.
1School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China, 2School of Public Health, The University of Hong Kong, Hong Kong, China.
1School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China, 2School of Public Health, The University of Hong Kong, Hong Kong, China.
OBJECTIVES: The global ageing population faces an increasing burden of visual impairment (VI) associated with age-related ocular disorders, which typically become clinically significant from around age 50. Regular comprehensive eye examinations enable early detection and timely management of ocular disorders to prevent VI. However, economic evidence on the optimal examination interval remains limited. This study aimed to evaluate the cost-effectiveness of strategies with varied intervals for regular comprehensive eye examinations.
METHODS: An individual-based state-transition model was developed to simulate the development and progression of four common age-related ocular conditions, uncorrected refractive error, age-related macular degeneration, glaucoma, and cataracts, in a hypothetical cohort of 1 million 50-year-old individuals in Hong Kong (HK). From a societal perspective, eleven strategies using different examination intervals for two age groups: 50-64 years (no examination, or every 1-5 years) and ≥65 years (every 1-2 years), were evaluated in the cost-effective model.
RESULTS: Screening individuals aged 50-64 years was cost-effective. Compared to no screening at 50-64, screening this group at a five-year interval gained quality-adjusted life-years (QALY) at a cost of US$1,382 per QALY gained, under the World Health Organization’s threshold of one times HK’s gross domestic product per capita (US$54,101 in 2024). Among all the strategies, annual examination for both the 50-64 and 65+ age groups was the most effective and was cost-effective. Probabilistic sensitivity analysis indicated that the most cost-effective strategies were biennial examinations at a willingness-to-pay (WTP) for a QALY between US$2,300-$8,700 and annual examinations for both age groups, when the WTP for a QALY was $8,700 or above.
CONCLUSIONS: From a societal perspective, initiating comprehensive eye examination at age 50 is a cost-effective strategy. The most cost-effective examination interval was once a year for people aged 50 and over, and the second most cost-effective was once every two years, depending on the WTP threshold.
METHODS: An individual-based state-transition model was developed to simulate the development and progression of four common age-related ocular conditions, uncorrected refractive error, age-related macular degeneration, glaucoma, and cataracts, in a hypothetical cohort of 1 million 50-year-old individuals in Hong Kong (HK). From a societal perspective, eleven strategies using different examination intervals for two age groups: 50-64 years (no examination, or every 1-5 years) and ≥65 years (every 1-2 years), were evaluated in the cost-effective model.
RESULTS: Screening individuals aged 50-64 years was cost-effective. Compared to no screening at 50-64, screening this group at a five-year interval gained quality-adjusted life-years (QALY) at a cost of US$1,382 per QALY gained, under the World Health Organization’s threshold of one times HK’s gross domestic product per capita (US$54,101 in 2024). Among all the strategies, annual examination for both the 50-64 and 65+ age groups was the most effective and was cost-effective. Probabilistic sensitivity analysis indicated that the most cost-effective strategies were biennial examinations at a willingness-to-pay (WTP) for a QALY between US$2,300-$8,700 and annual examinations for both age groups, when the WTP for a QALY was $8,700 or above.
CONCLUSIONS: From a societal perspective, initiating comprehensive eye examination at age 50 is a cost-effective strategy. The most cost-effective examination interval was once a year for people aged 50 and over, and the second most cost-effective was once every two years, depending on the WTP threshold.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE29
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)