Advances on the health economic evaluation of common blinding eye diseases screening

doi:10.3877/cma.j.issn.2095-2007.2021.02.006

Abstract

Abstract:

Diabetic retinopathy (DR), glaucoma, age-related macular degeneration (AMD), and cataract are common eye diseases worldwide, and are also the leading causes of visual impairment and blindness. In recent years, many countries and regions have carried out routine screening programs for the above eye diseases, and analyzed cost-effectiveness from the aspect of health economics. Whether screening for them alone or in combination at an early stage is cost-effective has not been determined. The health economic researches of eye diseases screening at home and abroad was summarized, which to provide reference for the early screening of common blinding eye diseases in China.

Key words: Health economic, Cataract, Glaucoma, Age-related macular degeneration, Diabetic retinopathy

Ruyue Li, Hanruo Liu. Advances on the health economic evaluation of common blinding eye diseases screening[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(02): 94-98.

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References 51

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作者	发表年份(年)	国家	对比方式	分析方法	效果指标	主要结果
Aoki等^[12]	2004	美国	远程筛查和常规筛查	CUA	成本或QALYs	远程筛查每增加18.73QALYs成本为16 514美元；常规筛查每增加18.58QALYs成本为17 590美元
Whited等^[16]	2005	美国	远程筛查和常规筛查	CEA	总成本	每增加一例接受PRP治疗的患者，成本增加1618美元；每避免一次严重的视力丧失事件，成本增加13 748美元
Li等^[17]	2012	美国	远程筛查和常规检查	CBA	直接成本	远程筛查和常规筛查成本分别为49.95美元和77.80美元
Kirkizlar等^[13]	2013	美国		CUA	成本或QALYs	当筛查数>3500人，年龄<80岁时，远程筛查对所有种族有成本效益
Richardson等^[15]	2013	美国	远程筛查和常规筛查	CMA	节约成本	远程筛查可以避免额外去眼科诊所就诊，每位患者节省153.53美元；需要筛查的患者越多，节省的费用越多
Brady等^[14]	2014	美国	远程筛查和不筛查	CMA	节约成本	在基本情况下，远程筛查可为每例患者节省36美元；蒙特卡罗模拟显示，平均每位患者可节省48美元
Phan等^[18]	2014	美国	远程筛查和门诊就诊	CMA	直接成本与投资回报的比	平均每台设备屏幕的成本降低了24.3美元，直接成本与投资回报的比为0.47，意味着53%投资成本得到回报。只有15%至少一只眼有DR的患者和20%至少有一幅不可读图像的患者需要转诊进行全面检查
Brown-Connolly等^[19]	2014	美国		CUA	直接成本与投资回报的比	投资回报率为15∶1，远程筛查每增加一个QALY节省100万美元
Gomez-Ulla等^[20]	2008	西班牙	远程筛查和常规筛查	CBA	直接成本	每位患者使用远程筛查人员、消耗品和设备的成本分别为2.69欧元、0.03欧元及1.62欧元。常规筛查的人员、消耗品和设备的资本成本分别为2.69欧元、0.11欧元及0.33欧元；每位患者有0.97欧元的旅行成本、14.97欧元的收入损失和48.29欧元的会诊费
Romero-Aroca等^[21]	2016	西班牙	2.5年筛查和年度筛查	CUA和CEA	成本或QALYs或ICER	每2.5年筛查一次时，成本为(482.85±35.14)欧元/人；对威胁视力的DR患者，成本为(1528.26±114.94)欧元/人。年度筛查时，每位DR患者的QALY增加0.77，ICER为1096.88欧元；每位DR患者的QALY增加0.6，ICER为4571.2欧元
Bjørvig等^[22]	2002	挪威	远程筛查和常规筛查	CMA	直接成本	患者数为20人/年时，远程筛查和常规筛查成本分别为8555挪威克朗/人和428挪威克朗/人；患者数为200人/年时，成本分别为971挪威克朗/人和1440挪威克朗/人；患者数为110人/年时，两种筛查方式成本相同
Ben等^[23]	2020	巴西	机会性就诊、常规筛查和远程筛查	CUA和CEA	成本或QALYs或ICER	与机会性就诊相比，每挽救1个QALY，远程筛查的增量成本为21 445巴西雷亚尔；常规筛查成本高于远程筛查，且效益更低。在世界卫生组织规定的最低和最高支付意愿门槛下，远程筛查比常规筛查更具成本效益的可能性分别为0.46和0.67
Tung等^[25]	2008	中国	筛查和不筛查	CUA和CEA	成本或QALYs或视力挽救年	每隔1、2、3、4及5年筛查一次时，每个视力挽救年的成本分别为20 962新台币、24 990新台币、30 847新台币、37 435新台币及44 449新台币；不筛查组每个视力挽救年的成本为83 411新台币。每隔1、2、3、4及5年筛查一次时，每个成本分别为21 924新台币、25 319新台币、30 098新台币、35 106新台币及40 037新台币；不筛查组每个QALY的成本为61 542新台币
Wu等^[24]	2015	中国	筛查和不筛查	CEA	总成本或视力或QALY或ICER	筛查间隔≥4年时，每增加一个QALY ICER<7485美元；每4年筛查一次QALY增量为11.066，且最多
Rachapelle等^[26]	2013	印度	一次性筛查、按照不同间隔定期筛查和不筛查	CUA	成本或QALYs	一次性筛查有成本效益，每增加一个QALY成本为1321美元；间隔不超过2年的筛查也有成本效益；年度筛查无成本效益，每增加一个QALY成本为3183美元

作者	发表年份(年)	国家	对比方式	分析方法	效果指标	主要结果
Aoki等^[12]	2004	美国	远程筛查和常规筛查	CUA	成本或QALYs	远程筛查每增加18.73QALYs成本为16 514美元；常规筛查每增加18.58QALYs成本为17 590美元
Whited等^[16]	2005	美国	远程筛查和常规筛查	CEA	总成本	每增加一例接受PRP治疗的患者，成本增加1618美元；每避免一次严重的视力丧失事件，成本增加13 748美元
Li等^[17]	2012	美国	远程筛查和常规检查	CBA	直接成本	远程筛查和常规筛查成本分别为49.95美元和77.80美元
Kirkizlar等^[13]	2013	美国		CUA	成本或QALYs	当筛查数>3500人，年龄<80岁时，远程筛查对所有种族有成本效益
Richardson等^[15]	2013	美国	远程筛查和常规筛查	CMA	节约成本	远程筛查可以避免额外去眼科诊所就诊，每位患者节省153.53美元；需要筛查的患者越多，节省的费用越多
Brady等^[14]	2014	美国	远程筛查和不筛查	CMA	节约成本	在基本情况下，远程筛查可为每例患者节省36美元；蒙特卡罗模拟显示，平均每位患者可节省48美元
Phan等^[18]	2014	美国	远程筛查和门诊就诊	CMA	直接成本与投资回报的比	平均每台设备屏幕的成本降低了24.3美元，直接成本与投资回报的比为0.47，意味着53%投资成本得到回报。只有15%至少一只眼有DR的患者和20%至少有一幅不可读图像的患者需要转诊进行全面检查
Brown-Connolly等^[19]	2014	美国		CUA	直接成本与投资回报的比	投资回报率为15∶1，远程筛查每增加一个QALY节省100万美元
Gomez-Ulla等^[20]	2008	西班牙	远程筛查和常规筛查	CBA	直接成本	每位患者使用远程筛查人员、消耗品和设备的成本分别为2.69欧元、0.03欧元及1.62欧元。常规筛查的人员、消耗品和设备的资本成本分别为2.69欧元、0.11欧元及0.33欧元；每位患者有0.97欧元的旅行成本、14.97欧元的收入损失和48.29欧元的会诊费
Romero-Aroca等^[21]	2016	西班牙	2.5年筛查和年度筛查	CUA和CEA	成本或QALYs或ICER	每2.5年筛查一次时，成本为(482.85±35.14)欧元/人；对威胁视力的DR患者，成本为(1528.26±114.94)欧元/人。年度筛查时，每位DR患者的QALY增加0.77，ICER为1096.88欧元；每位DR患者的QALY增加0.6，ICER为4571.2欧元
Bjørvig等^[22]	2002	挪威	远程筛查和常规筛查	CMA	直接成本	患者数为20人/年时，远程筛查和常规筛查成本分别为8555挪威克朗/人和428挪威克朗/人；患者数为200人/年时，成本分别为971挪威克朗/人和1440挪威克朗/人；患者数为110人/年时，两种筛查方式成本相同
Ben等^[23]	2020	巴西	机会性就诊、常规筛查和远程筛查	CUA和CEA	成本或QALYs或ICER	与机会性就诊相比，每挽救1个QALY，远程筛查的增量成本为21 445巴西雷亚尔；常规筛查成本高于远程筛查，且效益更低。在世界卫生组织规定的最低和最高支付意愿门槛下，远程筛查比常规筛查更具成本效益的可能性分别为0.46和0.67
Tung等^[25]	2008	中国	筛查和不筛查	CUA和CEA	成本或QALYs或视力挽救年	每隔1、2、3、4及5年筛查一次时，每个视力挽救年的成本分别为20 962新台币、24 990新台币、30 847新台币、37 435新台币及44 449新台币；不筛查组每个视力挽救年的成本为83 411新台币。每隔1、2、3、4及5年筛查一次时，每个成本分别为21 924新台币、25 319新台币、30 098新台币、35 106新台币及40 037新台币；不筛查组每个QALY的成本为61 542新台币
Wu等^[24]	2015	中国	筛查和不筛查	CEA	总成本或视力或QALY或ICER	筛查间隔≥4年时，每增加一个QALY ICER<7485美元；每4年筛查一次QALY增量为11.066，且最多
Rachapelle等^[26]	2013	印度	一次性筛查、按照不同间隔定期筛查和不筛查	CUA	成本或QALYs	一次性筛查有成本效益，每增加一个QALY成本为1321美元；间隔不超过2年的筛查也有成本效益；年度筛查无成本效益，每增加一个QALY成本为3183美元

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