Presentation (CTI)

OBJECTIVES: Myopia starting in childhood, has long-term visual complications (retinal detachment, cataracts, glaucoma and myopic macular degeneration) and is associated with significant lifetime burden. Incidence and prevalence is increasing, attributed to lifestyle changes. Appropriate model structure and parameterisation is essential to understand the cost-of-illness and the economic impact of the increasing number of myopia interventions. This study aims to assess existing models to inform the design of a new economic model.
METHODS: Studies included were model-based financial and/or health burden estimations and economic evaluations in paediatric myopia. A systematic review was performed (April 2026) using MEDLINE, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature and International Health Technology Assessment databases. Data extracted were model designs, model parameters and modelling/extrapolation techniques. QHES and AdViSHE checklists were utilised to assess methodological quality and model validation processes.
RESULTS: Seven model-based economic evaluations met the inclusion criteria. All studies were recent, published since 2022. Studies were from China (5), Wales (1) and New Zealand (1). Six studies utilised cohort-level Markov models, and one study used an individual-level model. Models differed in the inclusion of later-life ophthalmic complications, with only four studies including these diseases, and at varying levels of complexity. Studies differed in their use of extrapolation approaches and evidence. QHES scores reflected that studies were of fair quality overall (mean score: 67/100) but AdViSHE checklist adherence was poor, with the best-performing studies only meeting two checklist items.
CONCLUSIONS: This review found few models estimating the lifetime economic impact of paediatric myopia or the cost-effectiveness of its interventions. Included studies displayed suboptimal handling of the complexities of disease progression and incomplete inclusion of long-term complications. Future models need to be robust and reflect both myopic progression and long-term impact to inform policy and reimbursement discussions around this emerging public health issue.