Portable electronic vision enhancement systems in comparison with optical magnifiers for near vision activities: an economic evaluation alongside a randomized crossover trial.
OBJECTIVE
To determine the incremental cost-effectiveness of portable electronic vision enhancement system (p-EVES) devices compared with optical low vision aids (LVAs), for improving near vision visual function, quality of life and well-being of people with a visual impairment.


METHODS
An AB/BA randomized crossover trial design was used. Eighty-two participants completed the study. Participants were current users of optical LVAs who had not tried a p-EVES device before and had a stable visual impairment. The trial intervention was the addition of a p-EVES device to the participant's existing optical LVA(s) for 2 months, and the control intervention was optical LVA use only, for 2 months. Cost-effectiveness and cost-utility analyses were conducted from a societal perspective.


RESULTS
The mean cost of the p-EVES intervention was £448. Carer costs were £30 (4.46 hr) less for the p-EVES intervention compared with the LVA only control. The mean difference in total costs was £417. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £736 (95% CI £481 to £1525) for a 7% improvement in near vision visual function. Cost per quality-adjusted life year (QALY) ranged from £56 991 (lower 95% CI = £19 801) to £66 490 (lower 95% CI = £23 055). Sensitivity analysis varying the commercial price of the p-EVES device reduced ICERs by up to 75%, with cost per QALYs falling below £30 000.


CONCLUSIONS
Portable electronic vision enhancement system (p-EVES) devices are likely to be a cost-effective use of healthcare resources for improving near vision visual function, but this does not translate into cost-effective improvements in quality of life, capability or well-being.
Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, UK.
Nathan
http://orcid.org/0000-0001-7646-5435
N
Bray
North Wales Organisation for Randomised Trials in Health, Bangor, Gwynedd, UK.
Andrew
A
Brand
Faculty of Life Sciences, The University of Manchester, Manchester, UK.
John
J
Taylor
North Wales Organisation for Randomised Trials in Health, Bangor, Gwynedd, UK.
Zoe
Z
Hoare
Faculty of Life Sciences, The University of Manchester, Manchester, UK.
Christine
C
Dickinson
Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, UK.
Rhiannon T
RT
Edwards
D000368:Aged; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000191:economics / Q000295:instrumentation*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000534:rehabilitation*; D055096:Optical Devices; D011788:Quality of Life; D011932:Reading; D012682:Sensory Aids / Q000191:economics*; D011795:Surveys and Questionnaires; D015354:Vision, Low / Q000534:rehabilitation*; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000534:rehabilitation
economic evaluation; health economics; low vision aid; portable electronic vision enhancement system; visual impairment
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