A new economic analysis from Wales has found that certain myopia-control interventions for children—namely multifocal soft contact lenses (MFSCL) and overnight orthokeratology (ortho-k)—may be cost-effective alternatives to standard single-vision correction, when evaluated over a lifetime by NHS Wales.

Researchers conducted a cost-utility study comparing peripheral plus spectacle lenses (PPSL), MFSCL, and ortho-k against single-vision lenses. Drawing on data from a Cochrane review and meta-analyses, the model assessed lifetime costs and quality-adjusted life years (QALYs), with outcomes discounted annually

Key Findings

• PPSL offered minimal clinical benefit and higher cost than standard lenses.
• MFSCL generated a 0.28 QALY gain at an additional £4,040, resulting in an incremental cost-effectiveness ratio (ICER) of £8,367 per QALY—well below the typical UK threshold of £20,000
• Orthokeratology delivered 0.5 QALYs at an extra cost of £3,732, yielding a highly favorable ICER of £3,995 per QALY
  Probabilistic sensitivity analyses showed these ICERs staying under £20,000 in 71% of simulations for MFSCL and 90% for orthokeratology, with orthokeratology emerging as the most cost-effective option in 76% of scenarios

Budget modeling suggested widespread adoption of orthokeratology for children aged 6 to 15 years in Wales would cost around £66.9 million over 5 years, compared to £8.9 million for single-vision lenses, implying an incremental budget impact exceeding £58 million.

While costs of progression, interventions, and high myopia utility influenced outcomes, ortho-k retained its superiority across most sensitivity analyses. The study highlights remaining uncertainties—particularly regarding the long-term effects of these interventions and quality-of-life benefits—and calls for more UK-specific research.

Health Technology Wales supports routine use of ortho-k and MFSCLs, advocating their broader adoption to prevent long-term myopia-related complications.

Bottom Line

MFSCL and ortho-k are promising, cost-effective strategies under Welsh and broader UK perspectives for slowing childhood myopia—though long-term data and equity-access considerations remain vital next steps.

Bennett H, Britton A, O’Sullivan D, Lado F. Cost-effectiveness of myopia-control spectacles and contact lenses for children and adolescents in Wales. Cost Eff Resour Alloc. 2025 Jun 4;23(1):26. doi: 10.1186/s12962-025-00632-w