Abstract

DO.14.08

Screening for glaucoma – the aspect of the costs

Knauer C., Pfeiffer N.
Universitäts-Augenklinik Mainz

Objective: Glaucoma affects more than 67 million people worldwide. About 800 000 people in Germany suffer from glaucoma. Considering the ageing population in Germany, the number of incident cases of blindness due to glaucoma will increase by about 80% in the next 25 years. The health care costs in Germany for glaucoma add up to 443 million euros. This review about costs of screening for glaucoma was generated against this background.
Methods: The literature research was done using PubMed of the National Library of Medicine (www.ncbi.nlm.nih.gov; date: 05.12.2006). Search terms: 1.) cost* or burden or resource* or economic* [title/abstract] + glaucoma [title/abstract] + screening [title/abstract]: 65 results; 2.) cost* or burden or resource* or economic* [title/abstract] + glaucoma [title/abstract] + detection [title/abstract]: 31 results; 3.) glaucoma [title/abstract] + screening [title/abstract], limits: English, German, reviews: 70 results.
Results: Costs of screening for glaucoma per case amount to 500 to 7000 euros / detected glaucoma case, depending on whether the costs for devices were included or not. Estimates for cost effectiveness are estimated between 73.000 euros / year of vision saved and 33.000 euros / disability adjusted life year. Most authors consider this to be cost-inefficient. One frequently stated argument against glaucoma screening is the missing randomised clinical trial to show a significant impact of screening versus no screening. The search for the most adequate screening method should include the most recent diagnostic tests. An evaluation report from the NHS Health Technology Assessment Programme expected to be published in October 2007 will present the clinical and cost effectiveness of alternative models for screening for open angle glaucoma.
Conclusions: The desire for a glaucoma screening programme is still unbroken. Possible approaches may be new diagnostic tests, done by nurses for high risk groups, which can detect more than one eye disease.

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