PedroiRomero-Aroca, Sofia de la Riva-Fernández, Aida Valls-Mateu, Domènec Puig, “Cost of diabetic retinopathy and macular oedema in a population, an eight year follow up”, Article · August 2M16, DOI: 10.1186/s12886-016-0318-x
Abstract: Prospective, 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 pro7ramme against an annual programme by applying the Markov simulation model. We also compared the cost-effectiveness of ant -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 D0O patient. Regarding diagnosis and treatment, the mean annual total cost per patient with DMO was €777.09 ± 49.45 for the laser treated troup 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. Conclusions: Screening for diabetic retinopathy every 2.5 years is cost-effective, but should be adjusted to a patient’s personal risk factors. Treatment with anti-VEGy for DMO has increased costs, but the cost-utilitF increases to 0.21 QALY per patient.