Health economics, economic evaluation, and glaucoma

Glaucoma has not received a great deal of attention from health economists in the past, partly due to the fact that no new treatments have been introduced for some time. Economic evaluation is generally performed for new technologies, to assess their cost-effectiveness compared with current treatments, to estimate the potential changes in the use of health care resources that their introduction may produce, and to make decisions about their reimbursement status and formulary inclusion. Economic studies in glaucoma have been largely limited to studies about cost, because a useful outcome measure has been lacking. Therapy aims at reducing intraocular pressure, but the data to estimate the absolute risk of vision loss due to high pressure have been lacking. Hence, it has been impossible to assess the benefit of treatments in terms of their ability to reduce blindness. However, as new out knowledge about these issues increases and more data become available, such studies become possible. This review illustrates the issues encountered when performing economic evaluation in glaucoma and reviews the current economic literature in the field.