Active Myopia Management Methods Yield Favorable Lifetime Financial Return

Active myopia management (AMM) strategies may result in greater myopia reduction and involve similar or less financial costs over the course of one’s lifetime compared with traditional myopia management (TMM), according to a study published in the British Journal of Ophthalmology.

Researchers conducted a study to analyze lifetime cost factors accompanying myopia treatment. They compared TMM and AMM estimated costs in 2 countries for an 8-year-old patient presenting with -0.75 D cycloplegic refraction in both eyes.

The team used Medicare schedule fees, spectacle and contact lens price reference guides, and the Australian Pharmaceutical Benefits Scheme to estimate costs associated with myopia-related clinical care. They analyzed the cost of spectacle lenses, myopia control options such as multifocal contact lenses and atropine drops, and costs associated with the management of myopia-related complications. They also included transportation and productivity costs (a monetization of time spent receiving care). They discounted future costs at 3% per annum, adjusted to 2020 values.

AMM options included the following: low-dose atropine, antimyopia spectacle designs, antimyopia multifocal soft contact lenses, and orthokeratology.

Researchers noted the AMM options were more costly compared with TMM during childhood, but “balanced across a lifetime by reduced refractive progression, simpler corrective lenses, fewer lens replacements, reduced risk of eye disease and vision loss, and reduced management of myopia complications.” Overall, the least expensive option involved low-dose atropine in China.

After applying 3% annual discounting, researchers determined that the lifetime cost of antimyopia spectacles (U.S. $7280, 95% CI, $5246-$9888) is less expensive than TMM ($7437, 95% CI, $4953-$10,740) in Australia. In China, the lowest-cost AMM option is low-dose atropine ($4453, 95% CI, $2136-$9115), which is about half the cost of TMM ($8006, 95% CI, $3026-$13,707).

“Our estimates suggest the greatest impact on lifetime cost of myopia in Australia and China is the level of myopia reached,” according to the researchers. “The financial benefits of AMM are likely to be greatest in communities experiencing larger myopia progression, that is, in this comparison, more in China than Australia. While AMM options have upfront cost impacts in childhood, these are mostly balanced or exceeded across a lifetime by savings associated with the reduced myopia achieved.”

Limitations of the study include failure to consider potential productivity impact of uncorrected and undercorrected myopia, using an average cost of products instead of weighing costs by market share, and basing myopia complication risks on population-based evidence.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of authors’ disclosures.

Reference

Fricke TR, Sankaridurg P, Naduvilath T, et al. Establishing a method to estimate the effect of antimyopia management options on lifetime cost of myopia. Br J Ophthalmol. Published online March 9, 2022. doi:10.1136/bjophthalmol-2021-320318