Cost-effectiveness of monotherapy and combination therapy for myopia control in Chinese children.

In 30 seconds

This network meta-analysis and decision-analytic Markov model assessed the cost-effectiveness of 16 myopia-control strategies for Chinese children and adolescents, modelling eight-year-old children over eight years. Outcomes included changes in spherical equivalent refraction (SER), axial length (AL), and progression to high myopia. Outdoor activity was cost-saving while reducing myopic shift (incremental cost-effectiveness ratio [ICER] USD -18.29/dioptre); for AL, its ICER was USD -42.68/mm. At higher willingness-to-pay thresholds, repeated low-level red-light therapy was favoured for both outcomes, while 0.01% atropine plus DIMS was cost-effective for SER.

Key findings

• Outdoor activity had an ICER of USD -18.29/dioptre for SER reduction and USD -42.68/mm for AL reduction.
• At higher willingness-to-pay thresholds, 0.01% atropine plus DIMS was cost-effective for SER reduction (USD 660.74/D).
• Repeated low-level red-light therapy was favoured at higher thresholds for SER (USD 895.36/D) and AL (USD 2011.32/mm).
• Combination interventions improved prevention of high myopia compared with monotherapy; cost-effectiveness rankings were preserved across onset ages and regional economic settings.

Why it matters

The analysis compares both clinical outcomes and costs across single and combined strategies, offering a framework for considering myopia control under different budget constraints. Its findings distinguish lower-cost options from interventions favoured at higher willingness-to-pay thresholds, while highlighting that combination strategies may better prevent progression to high myopia than monotherapy.

What to keep in mind

The findings rely on a decision-analytic model and clinical and cost data from China; the authors note that long-term safety and effectiveness of repeated low-level red-light therapy require confirmation.