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

Myopia poses a major public health and economic burden in China, necessitating cost-effectiveness evaluations of control strategies. We aimed to assess cost-effectiveness of single/combined myopia control in children and adolescents to optimise strategies.

We conducted a network meta-analysis to evaluate the efficacy of myopia control interventions in Chinese children (aged 6-18 years). Annual changes in axial length (AL) and spherical equivalent refraction (SER) were the primary outcomes. Additionally, we used a decision-analytic Markov model with clinical and cost data from China to evaluate 16 myopia control strategies for eight-year-old children over eight years from a patient perspective, with 3% discounting. Strategies included monotherapies and combined therapies. Main outcomes were incremental cost per unit reduction in myopic shift (i.e. SER) or AL elongation, compared with single-vision lenses (SVLs). Markov cohort analysis simulated the proportion of individuals progressing to high myopia under various strategies. We assessed robustness through deterministic and probabilistic sensitivity analyses. We performed subgroup analyses by onset age (6, 10, and 12 years) and regional economic development.