Table 5

Clinical effectiveness and cost–utility analysis

Clinical effectiveness of alternative monitoring pathways (N=10 000)
PathwayConverted to glaucoma (n)Progressed to moderate glaucoma (n)Progressed to severe glaucoma (n)
Treat all (annual IOP only)22821708468
Biennial monitoring (secondary care)20731536343
Biennial monitoring (primary care)21141545365
NICE conservative20791528349
NICE intensive20601507336
Incremental cost, QALYs and incremental cost per QALY gained (ICER)
PathwayAverage total cost (£)Incremental cost (£)Average total QALYIncremental QALYsICER (£)
Treat all33939.7866
Biennial monitoring (secondary care)39565629.79320.006685 312
Biennial monitoring (primary care)46967409.7920Dominated*Dominated*
NICE conservative50873919.7923Dominated*Dominated*
NICE intensive686217769.7931Dominated*Dominated*
  • *Dominated, more costly and less effective than another alternative.

  • ICER, incremental cost-effectiveness ratio; IOP, intraocular pressure; NICE, National Institute for Health and Care Excellence; QALY, quality-adjusted life year.