OBJECTIVES: To compare the expected U.S. payer costs associated with screening and early treatment of glaucoma patients vs. non-screening of this asymptomatic progressive disease. METHODS: A 14-year economic model was developed to evaluate costs associated with biennial screening and early treatment and compare it to not-screening, resulting in patients presenting at slightly more advanced mild stages of this progressive disease. Total costs included screening costs, drug costs, office visits, and surgical treatments associated with glaucoma. Treatment costs and disease progression rates were taken from recently published literature. Non-screened patients were assigned zero costs for seven years followed by treatment costs for mild disease for seven years. Screened patients were assigned every-other-year screening cost for fourteen years, with a proportion of screened patients at risk assigned early/mild glaucoma treatment costs. Patient epidemiology rates were based on non-Medicare patients aged 40-64 years old. Multi-factor sensitivity analyses were conducted. RESULTS: Total expected costs to “screen and treat” over 14 years are estimated to be $8,910 per patient or $636 per patient per year compared to “not-screen” for 7 years followed by 7 years of treatment costs of $10,458 or $1,494 per patient per treated year. In sensitivity analyses, the difference in total expected plan costs varies around cost-neutral. CONCLUSIONS: Total expected payer costs for screening for glaucoma will be cost neutral over the early years of the disease and will be cost saving during the more expensive progressive years. Cost considerations must be balanced with patient concerns of advancing to blindness and patient/plan benefit with this new HEDIS measure.