Cost utility of screening and treatment for early age related macular degeneration with zinc and antioxidants.
OBJECTIVE
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 pound 22 722 per quality adjusted life year (QALY) saved. The cost per QALY decreased to pound 18 948 if photodynamic therapy with verteporfin savings were included.


CONCLUSIONS
Screening for, and prophylactic treatment of, early AMD is estimated to cost around pound 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.
Hopley
C
C
Centre for Vision Research, Department of Ophthalmology and the Westmead Millennium Institute, University of Sydney, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145, Australia.
Salkeld
G
G
Wang
J J
JJ
Mitchell
P
P
D000368:Aged; D000975:Antioxidants / Q000191:economics / Q000627:therapeutic use*; D001315:Australia; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D016527:Drug Costs; D005260:Female; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D018803:Models, Economic; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D015032:Zinc / Q000191:economics / Q000627:therapeutic use*
D000975:Antioxidants; D015032:Zinc