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The Cost-Effectiveness of Three Screening Alternatives for People with Diabetes with No or Early Diabetic Retinopathy
Health Services Research,
Rein DB et al. - Annual eye evaluations are costly and add little benefit compared with either plausible alternative. More research on the ability of telemedicine to detect other eye conditions is needed to determine whether it is more cost-effective than biennial eye evaluation.
Methods- Literature review, analysis of existing surveys.
- United Kingdom Prospective Diabetes Study, National Health and Nutrition Examination Survey, American Academy of Ophthalmology Preferred Practice Patterns, Medicare Payment Schedule.
- Cost-effectiveness Monte Carlo simulation.
- Biennial eye evaluation was the most cost-effective treatment option when the ability to detect other eye conditions was included in the model.
- Telemedicine was most cost-effective when other eye conditions were not considered or when telemedicine was assumed to detect refractive error.
- The current annual eye evaluation recommendation was costly compared with either treatment alternative. Self-referral was most cost-effective up to a willingness to pay (WTP) of U.S.$37,600, with either biennial or annual evaluation most cost-effective at higher WTP levels.
