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

Acta Ophthalmol. 2017 Aug;95(5):e415-e423. doi: 10.1111/aos.13255. Epub 2016 Sep 29.

Abstract

Purpose: To 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.

Methods: An 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 2 months, and the control intervention was optical LVA use only, for 2 months. Cost-effectiveness and cost-utility analyses were conducted from a societal perspective.

Results: The mean cost of the p-EVES intervention was £448. Carer costs were £30 (4.46 hr) less for the p-EVES intervention compared with the LVA only control. The mean difference in total costs was £417. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £736 (95% CI £481 to £1525) for a 7% improvement in near vision visual function. Cost per quality-adjusted life year (QALY) ranged from £56 991 (lower 95% CI = £19 801) to £66 490 (lower 95% CI = £23 055). Sensitivity analysis varying the commercial price of the p-EVES device reduced ICERs by up to 75%, with cost per QALYs falling below £30 000.

Conclusion: Portable 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.

Keywords: economic evaluation; health economics; low vision aid; portable electronic vision enhancement system; visual impairment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cost-Benefit Analysis
  • Cross-Over Studies
  • Equipment Design
  • Female
  • Humans
  • Image Processing, Computer-Assisted / economics
  • Image Processing, Computer-Assisted / instrumentation*
  • Male
  • Myopia / physiopathology
  • Myopia / rehabilitation*
  • Optical Devices*
  • Quality of Life*
  • Reading
  • Sensory Aids / economics*
  • Surveys and Questionnaires
  • Vision, Low / rehabilitation*
  • Visual Acuity*
  • Visually Impaired Persons / rehabilitation