Cost savings associated with detection and treatment of diabetic eye disease.

Abstract

Diabetic retinopathy, which leads to macular oedema and retinal neovascularisation, is the leading cause of blindness among working age Americans. Research has demonstrated significant cost savings associated with detection of eye disease in Americans and Europeans with insulin-dependent diabetes mellitus (IDDM, type I diabetes) and non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes). In this report, we estimate the current and potential savings in both the United States and in a European country resulting from the screening and treatment of retinopathy in persons with diabetes. Computer modelling, incorporating data from population-based epidemiological studies and multicentre clinical trials. Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings. Detection and treatment of diabetic eye disease in both the United States and Scandinavia is not only cost effective, but is actually cost saving from the governmental perspective. Potential savings in the United States exceed $US600 million annually, while, in Sweden, potential savings of 36 million SEK might be realised. These findings are comparable given the differences in population between the 2 countries. Our analysis indicates that prevention programmes aimed at improving eye care for persons with diabetes not only reduce needless vision loss, but also provide a financial return on the investment of public funds.