School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Public Health Research Group, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
J Glob Health. 2024 Sep 20;14:04183. doi: 10.7189/jogh.14.04183.
Myopia is a common eye condition and projected to affect half of the global population by 2050. Controlling its progression during childhood may prevent associated ocular diseases in later life. Certain interventions retard myopia progression but their long-term costs and consequences are not well understood. We evaluated the cost-effectiveness of myopia control via an optical approach using the Defocus Incorporated Multiple Segments (DIMS) lens over a lifetime.
We constructed an individual-based, state-transition model to simulate 1) the development and progression of myopia in childhood with and without control and 2) the impact of myopia on the development of four sight-threatening complications in adulthood. We compared strategies of myopia control with 100% uptake vs. no myopia control from the societal perspective to determine whether myopia control is value for money.
With myopia control, the cumulative prevalence of high myopia was relatively reduced by 44.7% (5.9 vs. 10.7%) and severe visual impairment by 19.2% (2.2 vs. 2.7%) compared to no myopia control. The lifetime cost per quality-adjusted life year gained was 26 407 US dollars (USD) and is considered cost-effective compared to the threshold recommended by the World Health Organization (WHO) of one times annual per capita gross domestic product (48 359 USD). Probabilistic sensitivity analysis showed that myopia control had an 87% likelihood of being cost-effective at the WHO threshold.
Myopia control is cost-effective when provided to all eligible children. Further investigation is required to determine if it is cost-effective for the government to subsidise myopia control in order to maximise access.
近视是一种常见的眼部疾病，预计到 2050 年，全球将有一半人口受到影响。在儿童时期控制近视的发展可能会预防日后生活中与近视相关的眼部疾病。某些干预措施可以减缓近视的进展，但它们的长期成本和后果尚不清楚。我们通过使用 Defocus Incorporated Multiple Segments（DIMS）透镜对近视进行光学控制，评估了这种方法在一生中的成本效益。
我们构建了一个基于个体的状态转移模型，以模拟 1）儿童时期近视的发展和进展，包括有控制和无控制两种情况，以及 2）近视对成年后四种视力威胁性并发症发展的影响。我们从社会角度比较了 100%采用近视控制策略与不控制近视的策略，以确定近视控制是否物有所值。
通过近视控制，与不控制近视相比，高度近视的累积患病率相对降低了 44.7%（5.9% vs. 10.7%），严重视力障碍降低了 19.2%（2.2% vs. 2.7%）。每获得一个质量调整生命年的终生成本为 26407 美元（USD），与世界卫生组织（WHO）推荐的每年人均国内生产总值（GDP）的一倍（48359 美元）相比，被认为是具有成本效益的。概率敏感性分析表明，近视控制在 WHO 阈值下有 87%的可能性具有成本效益。
为所有符合条件的儿童提供近视控制是具有成本效益的。需要进一步调查以确定政府是否有必要为近视控制提供补贴，以最大程度地扩大其受益人群。
