Cost-effectiveness of monitoring ocular hypertension based on a risk prediction tool

Wu, Hangjian, Gazzard, Gus, King, Anthony, Morgan, James ORCID: https://orcid.org/0000-0002-8920-1065, Wright, David, Crabb, David P., Takwoingi, Yemisi, Azuara-Blanco, Augusto, Watson, Verity and Hernández, Rodolfo 2024. Cost-effectiveness of monitoring ocular hypertension based on a risk prediction tool. BMJ Open Ophthalmology 9 (1) , e001741. 10.1136/bmjophth-2024-001741

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Abstract

Background/Aims: To assess the cost-effectiveness of making treatment decisions for patients with ocular hypertension (OHT) based on a risk prediction (RP) tool in the United Kingdom. Methods: A discrete event simulation model was constructed to compare the cost-effectiveness of an alternative care pathway in which the treatment decision was guided by a validated RP tool in secondary care against decision-making based on the standard care (SC). Individual patient sampling was used. Patients diagnosed with OHT and with an intraocular pressure of 24 mm Hg or over entered the model with a set of predefined individual characteristics related to their risk of conversion to glaucoma. These characteristics were retrieved from electronic medical records (n=5740). Different stages of glaucoma were modelled following conversion to glaucoma. Results: Almost all (99%) patients were treated using the RP strategy, and less than half (47%) of the patients were treated using the SC strategy. The RP strategy produced higher cost but also higher quality-adjusted life years (QALYs) than the SC strategy. The RP strategy was cost-effective compared with the SC strategy in the base-case analysis, with an incremental cost-effectiveness ratio value of £11 522. The RP strategy had a 96% probability of being cost-effective under a £20 000 per QALY threshold. Conclusions: The use of an RP tool for the management of patients with OHT is likely to be cost-effective. However, the generalisability of the result might be limited due to the high-risk nature of this cohort and the specific RP threshold used in the study.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Optometry and Vision Sciences
Additional Information:	License information from Publisher: LICENSE 1: URL: https://creativecommons.org/licenses/by/4.0/, Start Date: 2024-08-28, Type: open-access
Publisher:	BMJ Publishing Group
Date of First Compliant Deposit:	4 September 2024
Date of Acceptance:	3 July 2024
Last Modified:	04 Sep 2024 09:15
URI:	https://orca.cardiff.ac.uk/id/eprint/171805

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