Cost-effectiveness of detecting and treating diabetic retinopathy
Objective: To determine, from the health insurer's perspective, the cost of preventing vision
loss in patients with diabetes mellitus through ophthalmologic screening and treatment and
to calculate the cost-effectiveness of these interventions as compared with that of other
medical interventions. Design: Computer modeling, incorporating data from population-
based epidemiologic studies and multicenter clinical trials. Monte Carlo simulation was
used, combined with sensitivity analysis and present value analysis of cost savings. Results …
loss in patients with diabetes mellitus through ophthalmologic screening and treatment and
to calculate the cost-effectiveness of these interventions as compared with that of other
medical interventions. Design: Computer modeling, incorporating data from population-
based epidemiologic studies and multicenter clinical trials. Monte Carlo simulation was
used, combined with sensitivity analysis and present value analysis of cost savings. Results …
Objective
To determine, from the health insurer's perspective, the cost of preventing vision loss in patients with diabetes mellitus through ophthalmologic screening and treatment and to calculate the cost-effectiveness of these interventions as compared with that of other medical interventions.
Design
Computer modeling, incorporating data from population-based epidemiologic studies and multicenter clinical trials. Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings.
Results
Screening and treatment of eye disease in patients with diabetes mellitus costs 3190perquality-adjustedlife-year(QALY)saved.Thisaveragecostisaweightedaverage(basedonprevalenceofdisease)ofthecost-effectivenessofdetectingandtreatingdiabeticeyediseaseinthosewithinsulin-dependentdiabetesmellitus( 1996 per QALY), those with non–insulin-dependent diabetes mellitus (NIDDM) who use insulin for glycemic control (2933perQALY),andthosewithNIDDMwhodonotuseinsulinforglycemiccontrol( 3530 per QALY).
Conclusions
Our 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.
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