Factors affecting the lifetime cost of myopia and the impact of active myopia treatments in Europe

Abstract

YesPURPOSE: There are an increasing number of effective myopia control options available; however, their financial impacts are unclear. We estimated lifetime costs of myopia under 5 scenarios in France and the United Kingdom (UK): traditional myopia management (single vision correction), low-dose atropine, anti-myopia spectacles, anti-myopia soft contact lenses, and orthokeratology. DESIGN: Model-based cost estimate. METHODS: Each modeled scenario began with an 8-year-old child presenting with −0.75 DS. Natural progression data were used to determine the likelihood of possible refractive outcomes for children predicted to be at risk for faster and slower myopia progression until adulthood followed by an assumed exponential decay to zero progression by age 25 years. Societal care costs (direct and indirect) were collected from published sources, key informants, and informal surveys. Predicted progression rates for those at risk for slower and faster progression, costs, protocols, and risks were used to estimate and compare lifetime cost of myopia and its associated complications under each scenario. All future costs were discounted by 3% per year for sensitivity analysis. The main outcome measures were the lifetime cost of myopia, and cost ratio (myopia control cost divided by traditional care cost). RESULTS: Estimated lifetime cost of myopia using a traditional approach was US$32,492/US$22,606 for those predicted to experience faster/slower myopia progression in France, and US$48,170/US$29,664 in the UK. For those at risk for faster progression in France and the UK, cost ratios for the myopia control options ranged from 0.60 to 0.81, and 0.50 to 0.69, respectively. For those at risk for slower progression in France and the UK, the cost ratios ranged from 0.81 to 1.10, and 0.73 to 1.00, respectively. Female individuals incurred higher lifetime costs due to higher contact lens wear rates, prevalence of vision impairment, and longer life expectancy. CONCLUSIONS: Investment in myopia control during childhood in Europe likely reduces the total lifetime cost of myopia compared to traditional care via reduced refractive progression, need for complex lenses, and risk of pathology and vision loss. Children predicted to experience faster myopia progression derive the greatest economic advantage from myopia control.This project was funded by Thea Pharmaceuticals and Brien Holden Vision Institute , who have interests in myopia control. Finan- cial Disclosures: A.D.-N.: Nevaka, ORA, DopaV, Santen, Thea, Cooper Vision. D.B.G.: Cooper Vision, HOYA Vision Care, Johnson and Johnson, EssilorLuxottica, Santen, Thea, Zeiss. E.M.: Vyluma. K.S.: HOYA Vision Care, EssilorLuxottica, Santen UK Ltd, and Vyluma. L.L.: The Fred Hollows Foundation. N.G.-M.: Association of British Dispensing Opticians (ABDO), Alcon, British Contact Lens Association, British and Irish University and College Contact Lens Educators (BUCCLE; Chair), BMJ Open Ophthalmology (Associate Editor), CooperVision, College of Optometrists & Acuity, Eyerising International, Hoya, Menicon,Rodenstock, SILMO Academy. N.L.: Hoya, Essilor, Krys Group. S.R.: Vyluma, Hoya, EssilorLuxottica, Johnson and Johnson, Thea, SightGlass Vision. T.R.F.: Thea, Brien Holden Vision Institute, Victorian Lions Foundation, National Vision Research Institute Trusts