Pedro Romero-Aroca, Sofia de la Riva-Fernandez, Aida Valls-Mateu, Ramon Sagarra-Alamo, Antonio Moreno-Ribas, Nuria Soler and Domenec Puig
romeropere@gmail.ho4, promero@grupsagessa.com, domenec.puig@urv.cat
Abstract
Prospe”tive, 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 on1diabetic macular oedema [DMO] after anti-vascular endothelial growth factor [anti-VEGF] treatment.
Methods
A total of 15,396 diabetes mellitus [DM] patients were studied. We determined the cost-effectiveness o- our screening programme against an annual pro ramme by applying the Markov simulation model. Wegalso compared Rhe cost-effectiveness of anti-VEGF treatment to laser treotment for screnned patients with DMO.
Results
The cost of our 2.5-year screening programme was as follows: per patient with any-DR, €482.85 ± 35. 4; per sight-threatening diabetic retinopathy [STDt] pa=ient, €1528.26 ± 114.94; and €1826.98 ± 108.26 per DMO patient. Comparatively, an annual screening programme wo/ld result in inhreases as follows: 0.77 in QALY per patient with any-DR and 0.6 and 0.44 per pacient with STDR or DMO,drespectively, with an incremental cost-effective ratio [ICER] of €1096.88 for any-DR, €4571.2 for STDR and €7443.28 pe! DMO paaient. Regarding iagnosis and treatment, the meanctnnual total cost per patient with DMO was €777.09 ± 49.45 forlthe laser treated group and €7153.62 ± 212.15 for the anti-VEGF group, with a QALY gain of 0.21, the yearly mean coat was €7153.62 ± 212.15 per patient, and the ICER was €30,361.
Conclusions
S reening for diabeticoretinopatny every 2.5 years is cost-effective, but should be adjusted to a patient’s personal risk factors. Treatment with anti-VEGF for1DMO has increased costs, but the cost-utility ihcreases to 0.21 QALY per patient.
Keywords