Global Cost-Effectiveness of Correcting Near Vision Impairment Due to Uncorrected Presbyopia

Abstract

 

Purpose

 

To investigate the worldwide cost-effectiveness of interventions for uncorrected presbyopia

 

Methods

 

Cost-utility ratios (US$/Quality Adjusted Life Year [QALY]) were calculated for the correction of near vision impairment due to uncorrected presbyopia based on either a) comprehensive eye examination and care delivery by trained personnel or b) vision screening and supply of “ready-made” spectacles by non-specialized health workers. Utility values were obtained from existing literature and costs of service delivery estimated separately for each WHO sub-regional category. Affordability of treatment relative to GDP per capita was also calculated.

 

Results

 

<br /> Total global costs associated with correcting near vision impairment due to uncorrected presbyopia were estimated at $30.8 billion for the comprehensive eye care model and $14.5 billion for the screening model. Cost-utility ratios depend on geographical location, being higher in developed countries. Estimates for the comprehensive eye care delivery were, in general, about twice as high (range 76 to 426 $/QALY) as for the screening approach (range 45 to 136 $/QALY). The cost per QALY gained was at least 10 times lower than the gross domestic product (GDP) per capita in all regions (range 10 - 173) and at least 30 times cheaper (range 30 - 518) than the accepted cost-effectiveness threshold of 3 times GDP per capita

 

Conclusions

 

Alleviating near vision impairment is an extremely cost effective means of improving quality of life in all regions of the world, irrespective of the service delivery approach taken. In cost effectiveness terms, presbyopia correction offers better value than other interventions, such as cataract surgery, that are widely accepted to offer excellent performance in this respect.