Portable electronic vision enhancement systems in comparison with optical magnifiers for near vision activities: an economic evaluation alongside a randomized crossover trial

PurposeTo 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. MethodsAn 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 2months, and the control intervention was optical LVA use only, for 2months. Cost-effectiveness and cost-utility analyses were conducted from a societal perspective. ResultsThe mean cost of the p-EVES intervention was 448. Carer costs were 30 pound (4.46hr) less for the p-EVES intervention compared with the LVA only control. The mean difference in total costs was 417 pound. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of 736 pound (95% CI 481 pound to 1525) pound for a 7% improvement in near vision visual function. Cost per quality-adjusted life year (QALY) ranged from 56991 pound (lower 95% CI=19801) pound to 66490 pound (lower 95% CI=23055) pound. Sensitivity analysis varying the commercial price of the p-EVES device reduced ICERs by up to 75%, with cost per QALYs falling below 30000 pound. ConclusionPortable 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.