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RESEARCH STUDY

RESEARCH

Establishing a Method to Estimate the Effect of AntiMyopia Management Options on Lifetime Cost of Myopia

AUTHOR:

Tim R Fricke , Padmaja Sankaridurg, Thomas Naduvilath, Serge Resnikoff, Nina Tahhan, Mingguang He, Kevin D Frick

SPONSOR/INSTITUTION:

This work was supported by a public health grant from the Brien Holden Vision Institute, Sydney, Australia.

YEAR PUBLISHED:

2021

PUBLICATION:

British Journal of Ophthalmology

KEY HIGHLIGHTS:

  • Informed decisions on myopia management require an understanding of financial impact. We describe methodology for estimating lifetime myopia costs, with comparison across management options, using exemplars in Australia and China.

  • We demonstrate a process for modelling lifetime costs of traditional myopia management (TMM=full, single-vision correction) and active myopia management (AMM) options with clinically meaningful treatment efficacy. 

  • Evidence-based, location-specific and ethnicity-specific progression data determined the likelihood of all possible refractive outcomes. 

  • Myopia care costs were collected from published sources and key informants. 

  • Refractive and ocular health decisions were based on standard clinical protocols that responded to the speed of progression, level of myopia, and associated risks of pathology and vision impairment. 

  • We used the progressions, costs, protocols and risks to estimate and compare lifetime cost of myopia under each scenario and tested the effect of 0%, 3% and 5% annual discounting, where discounting adjusts future costs to 2020 value.

  • Low-dose atropine, antimyopia spectacles, antimyopia multifocal soft contact lenses and orthokeratology met our AMM inclusion criteria. 

  • Lifetime cost for TMM with 3% discounting was US$7437 (CI US$4953 to US$10 740) in Australia and US$8006 (CI US$3026 to US$13 707) in China. 

  • The lowest lifetime cost options with 3% discounting were antimyopia spectacles (US$7280, CI US$5246 to US$9888) in Australia and low-dose atropine (US$4453, CI US$2136 to US$9115) in China.

  • Financial investment in AMM during childhood may be balanced or exceeded across a lifetime by reduced refractive progression, simpler lenses, and reduced risk of pathology and vision loss. 

  • Our methodology can be applied to estimate cost in comparable scenarios.