DIABETIC RETINOPATHY
Cost Burden
An article on a study called The Economic Burden of Major Adult Visual Disorders in the United States showed that the annual total financial burden of major adult visual disorders is $35.4 billion ($16.2 billion in direct medical costs, $11.1 billion in other direct costs, and $8 billion in productivity losses) and that the annual governmental budgetary impact is $13.7 billion. Their conclusions were that major visual disorders among Americans older than 40 years result in substantial economic costs for the US economy. Well-designed public health programs may have the ability to reduce this burden in the future. 23
Another study on employees with Diabetic retinopathy showed thatannual direct costs were $18 218 (indirect = $3548) compared to $11 898 (indirect = $2374) for controls (Δ = $2032 (adjusted); p < 0.0001).
Costs differences were larger across DR employee subgroups:
- DME/non-DME ($28 606/$16 363)
- PDR/non-PDR ($30 135/$13 445; p < 0.0001)
- DR with/without photocoagulation ($34 539/$16 041; p < 0.0001)
- DR with/without vitrectomy ($63 933/$17 239; p < 0.0001).
Their conclusions were that DR employees had significantly higher costs than controls, and larger differences existed within DR subgroups. Indirect costs accounted for about 20% of total cost. 24
Cost effectiveness of detecting and treating diabetic retinopathy
Screening and treatment of eye disease in patients with diabetes mellitus costs $3190 per quality-adjusted life-year (QALY) saved. This average cost is a weighted average (based on prevalence disease) of the cost-effectiveness of detecting and treating diabetic eye disease in those with insulin-dependent diabetes mellitus ($1996 per QALY), those with non-insulin-dependent diabetes mellitus (NIDDM) who use insulin for glycemic control ($2933 per QALY), and those with NIDDM who do not use insulin for glycemic control ($3530 per QALY).
The conclusion is that their analysis indicates that prevention programs aimed at improving eye care for diabetic persons not only result in substantial federal budgetary savings but are highly cost-effective health investments for society. Ophthalmologic screening for diabetic persons is more cost-effective than many routinely provided health interventions. Because diabetic eye disease is the leading cause of new cases of blindness among working-age Americans, these results support the widespread use of screening and treatment for diabetic eye disease. 25
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