Cost of diabetic retinopathy and macular oedema in a population, an eight year follow up

BMC Ophthalmology

Research Article

Antonio Moreno-Ribas¹  Domenec Puig¹  Aida Valls-Mateu¹  Ramon Sagarra-Alamo²  Sofia de la Riva-Fernandez³  Nuria Soler³  Pedro Romero-Aroca⁴ 

[1] Department of Computer Engineering and Mathematics, University Rovira and Virgili, Reus, Spain;Health Care Area Reus-Priorat, Reus, Spain;Institut Catala de la Salut [ICS], Barcelona, Spain;Institut de Investigacio Sanitaria Pere Virgili [IISPV], University Rovira and Virgili, Reus, Spain;Ophthalmology Service, University Hospital Sant Joan, Institut de Investigacio Sanitaria Pere Virgili [IISPV], University Rovira and Virgili, Reus, Spain;Ophthalmology Service, University Hospital Sant Joan, Institut de Investigacio Sanitaria Pere Virgili [IISPV], University Rovira and Virgili, Reus, Spain;Hospital Universtario Sant Joan, Avenida. Doctor. Josep Laporte 2, 43204, Reus, Spain;

关键词: Diabetic retinopathy;    Diabetic macular oedema;    Telemedicine;    Cost of diabetic macular oedema;    Cost of diabetic retinopathy screening;   

DOI  :  10.1186/s12886-016-0318-x

 received in 2016-01-22, accepted in 2016-08-01,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundProspective, population-based study of an 8-year follow up.To determine the direct cost of diabetic retinopathy [DR], evaluating our screening programme and the cost of treating DR, focusing on diabetic macular oedema [DMO] after anti-vascular endothelial growth factor [anti-VEGF] treatment.MethodsA total of 15,396 diabetes mellitus [DM] patients were studied. We determined the cost-effectiveness of our screening programme against an annual programme by applying the Markov simulation model. We also compared the cost-effectiveness of anti-VEGF treatment to laser treatment for screened patients with DMO.ResultsThe cost of our 2.5-year screening programme was as follows: per patient with any-DR, €482.85 ± 35.14; per sight-threatening diabetic retinopathy [STDR] patient, €1528.26 ± 114.94; and €1826.98 ± 108.26 per DMO patient. Comparatively, an annual screening programme would result in increases as follows: 0.77 in QALY per patient with any-DR and 0.6 and 0.44 per patient with STDR or DMO, respectively, with an incremental cost-effective ratio [ICER] of €1096.88 for any-DR, €4571.2 for STDR and €7443.28 per DMO patient. Regarding diagnosis and treatment, the mean annual total cost per patient with DMO was €777.09 ± 49.45 for the laser treated group and €7153.62 ± 212.15 for the anti-VEGF group, with a QALY gain of 0.21, the yearly mean cost was €7153.62 ± 212.15 per patient, and the ICER was €30,361.ConclusionsScreening for diabetic retinopathy every 2.5 years is cost-effective, but should be adjusted to a patient's personal risk factors. Treatment with anti-VEGF for DMO has increased costs, but the cost-utility increases to 0.21 QALY per patient.

【 授权许可】

CC BY   
© The Author(s). 2016