Cost-effectiveness of polygenic risk profiling for primary open-angle glaucoma in the United Kingdom and Australia

Qinqin Liu, John Davis, Xikun Han, David A. Mackey, Stuart MacGregor, Jamie E. Craig, Lei Si, Alex W. Hewitt

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

BACKGROUND: Primary open-angle glaucoma (POAG) is the most common subtype of glaucoma. We evaluate the costeffectiveness of polygenic risk score (PRS) profiling as a screening tool for POAG.METHODS: We used a Markov cohort model to evaluate the cost-effectiveness of implementing PRS screening in the UK and Australia, conducted from the healthcare payer's perspective. We used published data to calculate prevalence, transition probabilities, utility, cost and other parameters in the model. Our main outcome measure was the incremental cost-effectiveness ratio (ICER) and secondary outcomes were years of blindness avoided and a "Blindness ICER'. We did one-way as well as two-way deterministic and probabilistic sensitivity analyses. RESULTS: The proposed screening programme for POAG in the UK is predicted to result in ICER of 24,783 pound (95% CI: 13,373-66,960) pound and would avoid 1 year of blindness at ICER of 10,095 pound (95% CI: 5513-27,656) pound. In Australia, it is predicted to result in ICER of AU$34,252 (95% CI: AU$21,324-95,497) and would avoid 1 year of blindness at ICER of AU$13,359 (95% CI: AU $8143-37,448). Using the willingness to pay thresholds of $54,808 and 30,000 pound, the proposed screening model is 79.2% likely to be cost-effective in Australia and is 60.2% likely to be cost-effective in the UK, respectively. CONCLUSION: We describe and model the cost-efficacy of incorporating a polygenic risk score for POAG screening in Australia and the UK for the first time and results indicated this is a promising cost-effectiveness strategy.
Original languageEnglish
Pages (from-to)2335-2343
Number of pages9
JournalEye
Volume37
Issue number11
Early online date13 Dec 2022
DOIs
Publication statusPublished - Aug 2023

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