Effect of patient's life expectancy on the cost-effectiveness of treatment for ocular hypertension.
OBJECTIVE
To assess the influence of expected life span on the cost-effectiveness of treating ocular hypertension to prevent primary open-angle glaucoma.


METHODS
We used a Markov simulation model to estimate the cost and benefit of ocular hypertension treatment over a person's remaining life. We examined the influence of age on the cost-effectiveness decision in 2 ways: (1) by evaluating specific age cohorts to assess the influence of age at the initiation of treatment; and (2) by evaluating the influence of a specific life span.


RESULTS
At a willingness to pay $50,000/quality-adjusted life year to $100,000/quality-adjusted life year, treatment of people with a 2% or greater annual risk of developing glaucoma was cost-effective for people aged 45 years with a life expectancy of at least 18 remaining years. However, to be cost-effective, a person aged 55 years must have a life expectancy of 21 remaining years and someone aged 65 years must have a life expectancy of 23 remaining years.


CONCLUSIONS
A person with ocular hypertension must have a life expectancy of at least 18 remaining years to justify treatment at a threshold of a 2% or greater annual risk of developing glaucoma. Persons at higher levels of risk require a life expectancy of 7 to 10 additional years to justify treatment.
Kymes
Steven M
SM
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Campus Box 8096, 660 S Euclid Ave, St Louis, MO 63110-1093, USA. kymes@vrcc.wustl.edu
Plotzke
Michael R
MR
Kass
Michael A
MA
Boland
Michael V
MV
Gordon
Mae O
MO
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data; D005902:Glaucoma, Open-Angle / Q000517:prevention & control; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008017:Life Expectancy; D008390:Markov Chains; D008875:Middle Aged; D015233:Models, Statistical; D009798:Ocular Hypertension / Q000188:drug therapy / Q000191:economics*; D010361:Patients; D019057:Quality-Adjusted Life Years; D012307:Risk Factors
D000959:Antihypertensive Agents
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