Lee Ling, De Angelis Laura, Barclay Erica, Tahhan Nina, Saunders Kathryn, McConnell Emma, Ghorbani-Mojarrad Neema, Dahlmann-Noor Annegret, Jaselsky Anton, Leveziel Nicolas, Bremond-Gignac Dominique, Resnikoff Serge, Fricke Timothy R
National Vision Research Institute (L.L., L.D.A., E.B., T.R.F.), Australian College of Optometry, Melbourne, Australia; School of Optometry and Vision Science (L.L., N.T., S.R., T.R.F.), University of New South Wales, Sydney, Australia.
National Vision Research Institute (L.L., L.D.A., E.B., T.R.F.), Australian College of Optometry, Melbourne, Australia.
Am J Ophthalmol. 2025 Oct;278:212-221. doi: 10.1016/j.ajo.2025.06.034. Epub 2025 Jun 20.
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.
Model-based cost estimate.
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).
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.
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.
目前有越来越多有效的近视控制方法；然而，它们对经济的影响尚不清楚。我们估算了在法国和英国的5种情况下近视的终生成本：传统近视管理（单焦点矫正）、低剂量阿托品、抗近视眼镜、抗近视软性隐形眼镜和角膜塑形术。
基于模型的成本估算。
每个建模场景都以一名8岁、近视度数为-0.75DS的儿童开始。利用自然进展数据来确定预计有近视进展较快和较慢风险的儿童在成年前可能的屈光结果的可能性，然后假定到25岁时进展呈指数衰减至零。社会护理成本（直接和间接）来自已发表的资料、关键信息提供者和非正式调查。利用预测的进展较慢和较快风险人群的进展率、成本、方案和风险，来估算和比较每种情况下近视及其相关并发症的终生成本。所有未来成本每年按3%进行贴现以进行敏感性分析。主要结局指标是近视的终生成本和成本比率（近视控制成本除以传统护理成本）。
对于预计在法国近视进展较快/较慢的人群，采用传统方法估算的近视终生成本分别为32,492美元/22,606美元，在英国为48,170美元/29,664美元。对于在法国和英国有较快进展风险的人群，近视控制方法的成本比率分别为0.60至0.81和0.50至0.69。对于在法国和英国有较慢进展风险的人群，成本比率分别为0.81至1.10和0.73至1.00。由于隐形眼镜佩戴率较高、视力损害患病率较高以及预期寿命较长，女性个体的终生成本更高。
与传统护理相比，在欧洲儿童期对近视控制进行投资可能会通过减少屈光进展、对复杂镜片的需求以及病理和视力丧失风险，降低近视的终生总成本。预计近视进展较快的儿童从近视控制中获得的经济优势最大。
