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Economic considerations of the diagnosis and management for glaucoma in the developed world.
MedLine Citation:
PMID:  21192264     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: This review evaluates the last 18-month literature related to costs and glaucoma. The emphasis is to look at evidence as a big picture and evaluate the critical points and challenges in methodology, current knowledge and future research. RECENT FINDINGS: On the basis of simulation models, treating glaucoma appears to be cost-effective compared with no treatment. The results of the simulation models are, however, not consistent regarding when to treat ocular hypertension and when comparing different therapeutic interventions. Most models simulated starting treatment with prostaglandins compared with other medications, whereas one study simulated also initial laser therapy which appeared to be cost saving compared with medical therapy. The models utilized input data both from randomized controlled trials (ideal outcomes) and observational studies (with incomplete and selective reporting). Models suffer from unreliability of data, for example data from randomized diagnostic trials, empirical data of utility values and glaucoma-induced visual disability are limited. SUMMARY: As the number of economic evaluations increases, the interpretation and evaluation of their extensive reporting appears very challenging. The published studies highlight the range of uncertainties due to the shortages of our current knowledge and evidence. There is a need for reliable and 'realistic' data for economic evaluations, preferably data from pragmatic randomized trials of 'usual patients'. Similar to emphasizing the cost-effectiveness of care, there is a need to evaluate the expected payback and cost-effectiveness of research interventions. However, even high-quality evidence cannot help our patients if we do not adopt cost-effective interventions.
Authors:
Anja Tuulonen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-29
Journal Detail:
Title:  Current opinion in ophthalmology     Volume:  -     ISSN:  1531-7021     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011108     Medline TA:  Curr Opin Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aEye Centre, Tampere University Hospital, Tampere, Finland bDepartment of Ophthalmology, University of Oulu, Oulu, Finland.
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