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Br J Ophthalmol 2004;88:450-454 doi:10.1136/bjo.2003.035279
  • Value-based ophthalmology

Cost utility of screening and treatment for early age related macular degeneration with zinc and antioxidants

  1. C Hopley1,
  2. G Salkeld2,
  3. J J Wang1 and
  4. P Mitchell1
  1. 1Centre for Vision Research, Department of Ophthalmology and the Westmead Millennium Institute, University of Sydney, Australia
  2. 2School of Public Health, University of Sydney, Australia
  1. Correspondence to: Professor Paul Mitchell University of Sydney Department of Ophthalmology, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia; paul_mitchellwmi.usyd.edu.au
  • Accepted 25 October 2003

Abstract

Aim: To assess the cost effectiveness of high dose zinc and antioxidants for delaying and reducing the progression of early age related macular degeneration (AMD).

Background: AMD is the leading cause of severe vision impairment and blindness in older people throughout the developed world. It currently affects around 420 000 people in the United Kingdom.

Methods: A cost utility analysis (CUA) was conducted to estimate the cost per quality adjusted life year (QALY) for screening a cohort of men and women, aged 55 years and over, for early AMD and then treating them with zinc and antioxidants. The incremental CUA was based on a decision analytic model, comparing screening with a no screening comparator (current practice). Extensive one way sensitivity analysis of parameters was conducted to determine the robustness of the model.

Results: In this model the cost effectiveness of screening for early AMD was £22 722 per quality adjusted life year (QALY) saved. The cost per QALY decreased to £18 948 if photodynamic therapy with verteporfin savings were included.

Conclusions: Screening for, and prophylactic treatment of, early AMD is estimated to cost around £22 700 per QALY saved. This cost falls within accepted levels to warrant further investigation. These findings have implications for ophthalmic practice and healthcare planning.

Notes

  • This study was supported by an Initiating Grant from the Westmead Millennium and Save Sight Institutes, University of Sydney.

  • Series editors: Melissa Brown and Gary Brown

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