Treating ocular hypertension appears cost-effective only in patients younger than 65

Researchers used a Markov simulation model to estimate the costs and benefits of treating a patient with ocular hypertension over his remaining lifespan. 

With cost effectiveness defined as willingness to spend $50,000 to $100 000/quality adjusted life year, they found that it is cost-effective to treat a patient who has a 2 percent or greater annual risk of developing glaucoma only when the person is aged 45 and has a life expectancy of more than 20 remaining years. Treatment of those aged 55 requires a life expectancy of 24 remaining years. Treatment of people older than 65 did not meet most accepted standards of cost-effectiveness.

The authors concluded that a person with ocular hypertension must have a life expectancy of at least 18 remaining years to justify treatment at a threshold of a 2 percent or greater annual risk of developing glaucoma. However, the patient's attitude toward treatment and disease progression remains an important factor in determining the cost effectiveness of treatment.