Cost Comparison Between Defocus Spectacle Lens and Compound Atropine in Myopia Treatment in the Portuguese Setting
DOI:
https://doi.org/10.48560/rspo.32886Keywords:
Atropine/therapeutic use, Cost-Effectiveness Analysis, Eyeglasses, Lenses, Intraocular, Myopia/therapyAbstract
INTRODUCTION: The rising prevalence of myopia poses a substantial global concern. Low concentration atropine and defocus spectacle lens (DSL) are the most widely used myopia prevention treatment in Portugal. Atropine drops must be compounded in pharmacies, because there is still no commercial low concentration atropine approved in Portugal. There are no studies with enough evidence to prefer one treatment over the other, so cost might be a decisive factor. Our purpose was to compare the costs between DSL and compound atropine for myopia progression prevention in Portugal.METHODS: We collected data on compound atropine from different pharmacies in Portugal, monofocal (MF) lenses prices from the four most common brands in Portugal and DSL price from brand representatives. Cost estimates were done per year of four consecutive years of myopia prevention treatment, considering different scenarios according to the need of spectacle lens exchange. We compared costs of low dose compound atropine plus MF lens versus DSL in the different scenarios.
RESULTS: Atropine treatment proved more cost-effective than DSL treatment only when there was a requirement for lens exchange every 6 months or less (609.25€ for atropine versus 780.00€ for DSL per year of treatment). When myopia progression prevention is more effective and the need of lens exchange is equal or greater than 12 months, DSL treatment showed to be less expensive than mean values of atropine treatment plus MF lens (390.00€ for DSL vs 464.59€ for atropine, per year of treatment).
CONCLUSION: DSL take a cost advantage in prevention of myopia progression, in situations when there is a need of lens exchange within once a year or less frequently. However, atropine plus MF lenses might be a less expensive in cases whenever there is a need of lens exchange every 6 months or more frequently. It is essential to conduct further studies focusing on the cost-effectiveness of different treatment options for preventing myopia progression.
Downloads
References
Jonas JB, Ang M, Cho P, Guggenheim JA, He MG, Jong M, et al. IMI Prevention of Myopia and Its Progression. Invest Ophthalmol Vis Sci. 2021;62:6. doi:10.1167/iovs.62.5.6
Fricke TR, Jong M, Naidoo KS, Sankaridurg P, Naduvilath TJ, Ho SM, et al. Global prevalence of visual impairment associated with myopic macular degeneration and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling. Br J Ophthalmol. 2018;102:855-62. doi:10.1136/bjophthalmol-2017-311266
Chia A, Lu QS, Tan D. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2: Myopia Control with Atropine 0.01% Eyedrops. Ophthalmology. 2016;123:391-9. doi:10.1016/j.ophtha.2015.07.004
Lam CS, Tang WC, Tse DY, Lee RP, Chun RK, Hasegawa K, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. Br J Ophthalmol. 2020;104:363. doi:10.1136/bjophthalmol-2018-313739
Bao J, Huang Y, Li X, Yang A, Zhou F, Wu J, et al. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmol. 2022;140:472-8. doi: 10.1001/jamaophthalmol.2022.0401.
Lam CS, Tang WC, Lee PH, Zhang HY, Qi H, et al. Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children: results of a 3-year follow-up study. Br J Ophthalmol. 2022;106:1110-4. doi: 10.1136/bjophthalmol-2020-317664.
Lam CS, Tang WC, Zhang HY, Lee PH, Tse DY, Qi H, et al. Long-term myopia control effect and safety in children wearing DIMS spectacle lenses for 6 years. Sci Rep. 2023;13:5475. doi: 10.1038/s41598-023-32700-7.
The International Agency for the Prevention of Blindness (IAPB). WSPOS Myopia Consensus Statement 2023. [accessed Jan 2023] Available: https://www.iapb.org/learn/resources/wspos-myopia-consensus-statement-2023/
Nucci P, Lembo A, Schiavetti I, Shah R, Edgar DF, Evans BJ. A comparison of myopia control in European children and adolescents with defocus incorporated multiple segments (DIMS) spectacles, atropine, and combined DIMS/atropine. PLoS One. 2023;18:e0281816. doi:10.1371/journal.pone.0281816
Guimarães S, Barros da Silva P, Oliveiros B, Silva E. Myopia control: short-term effect of 0.01% atropine vs. defocus incorporated multiple segment lenses-a retrospective study in European children. Int Ophthalmol. 2023;43:3777-84. doi: 10.1007/s10792-023-02788-x.
Fricke TR, Sankaridurg P, Naduvilath T, Resnikoff S, Tahhan N, He M, et al. Establishing a method to estimate the effect of antimyopia management options on lifetime cost of myopia. Br J Ophthalmol. 2023;107:1043-50. doi: 10.1136/bjophthalmol-2021-320318.
Hoskin AK, Philip S, Dain SJ, Mackey DA. Spectacle-related eye injuries, spectacle-impact performance and eye protection. Clin Exp Optom. 2015;98:203-9. doi: 10.1111/cxo.12283
Chua SY, Foster PJ. The Economic and Societal Impact of Myopia and High Myopia. In: Ang M, Wong TY, editors. Updates on Myopia: A Clinical Perspective. Singapore: Springer; 2020. p.53-63.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Sociedade Portuguesa de Oftalmologia
This work is licensed under a Creative Commons Attribution 4.0 International License.
CC BY
Do not forget to download the Authorship responsibility statement/Authorization for Publication and Conflict of Interest.
The article can only be submitted with these two documents.
To obtain the Authorship responsibility statement/Authorization for Publication file, click here.
To obtain the Conflict of Interest file (ICMJE template), click here
