[Health-economic aspects of glaucoma screening].
OBJECTIVE
Screening for glaucoma can detect undiagnosed patients, and treatment can prevent blindness. There are defined criteria for screening programs, but economic aspects of screening programs and cost utility estimations are of increasing importance.


METHODS
Medical databases (CDSR, HTA, MEDLINE, EMBASE) were searched on the topics of glaucoma screening, screening strategies and tools, and relevant health-economic analyses for glaucoma screening. In this article, the most important findings are presented and discussed using epidemiological data.


RESULTS
Glaucoma screening meets most of the relevant criteria for screening strategies. The best single screening test at this time is the frequency doubling technique. The cost-effectiveness depends mainly on the prevalence of the disease, the specificity of the screening test, the costs of screening and disease, and the impairment of quality of life due to glaucoma. Two recently published cost utility studies from Finland and the United Kingdom are presented. A common result is that a population screening is not cost-effective, whereas targeted screening of high-risk groups is.


CONCLUSIONS
Glaucoma screening of the general population is not cost-effective, but screening of groups at risk (e.g., those of a certain age, family history, or ethnicity) may be cost-effective. Clear cutoff points regarding whom to screen can be determined by economic analyses using high-quality data. These data influence health policy decision makers.
Hirneiss
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Augenklinik der Ludwig-Maximilians-Universität, Mathildenstrasse 8, 80336, München, Deutschland. Christoph.Hirneiss@med.uni-muenchen.de
Niedermaier
A
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Kernt
M
M
Kampik
A
A
Neubauer
A S
AS
D000328:Adult; D000368:Aged; D001766:Blindness / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004867:Equipment Design; D005260:Female; D005858:Germany; D005901:Glaucoma / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000295:instrumentation; D008875:Middle Aged; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D011237:Predictive Value of Tests; D019057:Quality-Adjusted Life Years; D012307:Risk Factors