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Y. Liang, N.L. Wang, T.C. Ye, S.Z. Li; Health–Economics Evaluation of Community Screening of Primary Angle Closure Glaucoma in Mainland of China . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4401.
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Primary angle closure glaucoma was a big problem in China, as estimated by Paul J Foster, more than 9,100,000 population expected to have primary angle closure and 2,800,000 population were exposed to occludable angle. However, the incidence rate of PACG was relatively low. This study was to make a health–economics evaluation of community screening of PACG based on a longitudinal community–based study in Guangzhou city of South China.
Number of need to treat (NNT) was used to re–analyze the results of six–year follow–up of PACG suspects in Guangzhou conducted by Tiancai Ye et al and several cross–sectional clinical and population studies. Cost–effectiveness and cost–utility were analyzed.
The mean age of PACG onset was 57∼58 y/o, the mean age of blindness onset was 65 y/o, the mean expected life span of Chinese has been reported to be 72 y/o. In Tiancai Ye et al’s study, the incidence rate of PACG was 30.5/10,000 in population aged ≥40 yrs within 6 years. To reduce a case of PACG, nearly 327 people should be screened, and 24 suspects should undergo laser iridotomy, the total cost would be $953 in China. To reduce one case of PACG blindness, the total cost would be $9,530,9.2 quality adjusted life years (QALYs) could be saved, and the cost/utilize value was 1,030$/QALY.It was 5 times higher than the cost of cataract screening in Mainland of China.
Although PACG is a big health problem in China, it isn’t a cost–effective way to do mass screening for PACG only. Strategies of combination with other preventable blindness diseases and a reasonable interval of screening should be considered.
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