The economic burden of diabetic retinopathy in Germany in 2002

Happich, Michael; Reitberger, U; Breitscheidel, Lusine; Ulbig, Michael W.; Watkins, J

doi:10.1007/s00417-007-0573-x

Cited by 57 publications

(48 citation statements)

References 14 publications

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“…The costs of PDR (€257), maculopathy (€216) and of both complications combined (€433) reported here could, however, be compared with the results of a German study [15] and a Canadian study [37]. Including only costs for ophthalmologist fees, medication and hospitalisation-corresponding to our definition of healthcare costs-the estimations from the German study give an average cost of €468 for patients with PDR and €681 for macular oedema.…”

Section: Discussionmentioning

confidence: 90%

“…In the USA, the total direct medical costs of DR in adults have been estimated at €342 (US$493) million per year and the average treatment cost per patient with DR at €436 (US $629) per year [14]. The societal cost of DR in Germany for the year 2002 has been estimated [15] to be €1433 per patient. However, to our knowledge no study to date has presented costs of DR specified by severity level among type 1 as well as type 2 diabetes patients using a population-based approach.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and healthcare costs of diabetic retinopathy: a population-based register study in Sweden

et al. 2010

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Aims/hypothesis The aim of the present study was to estimate the prevalence and healthcare costs of diabetic retinopathy (DR). Methods This population-based study included all residents (n=251,386) in the catchment area of the eye clinic of Linköping University Hospital, Sweden. Among patients with diabetes (n=12,026), those with and without DR were identified through register data from both the Care Data Warehouse in Östergötland, an administrative healthcare register, and the Swedish National Diabetes Register. Healthcare cost data were elicited by record linkage of these two registers to data for the year 2008 in the Cost Per Patient Database developed by Östergötland County Council. Results The prevalence of any DR was 41.8% (95% CI 38.9-44.6) for patients with type 1 diabetes and 27.9% (27.1-28.7) for patients with type 2 diabetes. Sightthreatening DR was present in 12.1% (10.2-14.0) and 5.0% (4.6-5.4) of the type 1 and type 2 diabetes populations respectively. The annual average healthcare cost of any DR was €72 (€53-91). Stratified into background retinopathy, proliferative DR, maculopathy, and the last two conditions combined, the costs were €26 (€10-42), €257 (€155-359), €216 (€113-318) and €433 (€232-635) respectively. The annual cost for DR was €106 000 per 100,000 inhabitants. Conclusions This study presents new information on the prevalence and costs of DR. Approximately one-third of patients with diabetes have some form of DR. Average healthcare costs increase considerably with the severity of DR, which suggests that preventing progression of DR may lower healthcare costs.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Prevalence and healthcare costs of diabetic retinopathy: a population-based register study in Sweden

et al. 2010

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“…Severity of ME in the worst affected eye was used as follows: no ME, no clinically significant ME (NCSME), and clinically significant ME (CSME). The details of the study methodology are published elsewhere [9]. To retrieve data on patientreported outcomes, interviews with the patients were undertaken.…”

Section: Methodsmentioning

confidence: 99%

Diabetic retinopathy and health-related quality of life

Davidov

Breitscheidel²,

Clouth

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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“…With the increase in diabetes, the economic burden that DR places on society is high. 40,41 In the UK, it was estimated in 2006 that the lifetime costs of dealing with retinopathy can be up to £237,000 per person in the working age group, and that up to 50% of these costs are accounted for by the loss of productivity as a result of blindness or vision impairment. 42 Therefore, if 1000 cases of DR could be avoided in the working age population, the potential savings to the government could be in excess of £237M.…”

Section: Introductionmentioning

confidence: 99%

Development of a cost-effectiveness model for optimisation of the screening interval in diabetic retinopathy screening

Scanlon

Aldington

Leal

et al. 2015

Health Technol Assess

106

167

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BackgroundThe English NHS Diabetic Eye Screening Programme was established in 2003. Eligible people are invited annually for digital retinal photography screening. Those found to have potentially sight-threatening diabetic retinopathy (STDR) are referred to surveillance clinics or to Hospital Eye Services.ObjectivesTo determine whether personalised screening intervals are cost-effective.DesignRisk factors were identified in Gloucestershire, UK using survival modelling. A probabilistic decision hidden (unobserved) Markov model with a misgrading matrix was developed. This informed estimation of lifetime costs and quality-adjusted life-years (QALYs) in patients without STDR. Two personalised risk stratification models were employed: two screening episodes (SEs) (low, medium or high risk) or one SE with clinical information (low, medium–low, medium–high or high risk). The risk factor models were validated in other populations.SettingGloucestershire, Nottinghamshire, South London and East Anglia (all UK).ParticipantsPeople with diabetes in Gloucestershire with risk stratification model validation using data from Nottinghamshire, South London and East Anglia.Main outcome measuresPersonalised risk-based algorithm for screening interval; cost-effectiveness of different screening intervals.ResultsData were obtained in Gloucestershire from 12,790 people with diabetes with known risk factors to derive the risk estimation models, from 15,877 people to inform the uptake of screening and from 17,043 people to inform the health-care resource-usage costs. Two stratification models were developed: one using only results from previous screening events and one using previous screening and some commonly available GP data. Both models were capable of differentiating groups at low and high risk of development of STDR. The rate of progression to STDR was 5 per 1000 person-years (PYs) in the lowest decile of risk and 75 per 1000 PYs in the highest decile. In the absence of personalised risk stratification, the most cost-effective screening interval was to screen all patients every 3 years, with a 46% probability of this being cost-effective at a £30,000 per QALY threshold. Using either risk stratification models, screening patients at low risk every 5 years was the most cost-effective option, with a probability of 99-100% at a £30,000 per QALY threshold. For the medium-risk groups screening every 3 years had a probability of 43 –48% while screening high-risk groups every 2 years was cost-effective with a probability of 55–59%.ConclusionsThe study found that annual screening of all patients for STDR was not cost-effective. Screening this entire cohort every 3 years was most likely to be cost-effective. When personalised intervals are applied, screening those in our low-risk groups every 5 years was found to be cost-effective. Screening high-risk groups every 2 years further improved the cost-effectiveness of the programme. There was considerable uncertainty in the estimated incremental costs and in the incremental QALYs, particularly with regard to implications of an increasing proportion of maculopathy cases receiving intravitreal injection rather than laser treatment. Future work should focus on improving the understanding of risk, validating in further populations and investigating quality issues in imaging and assessment including the potential for automated image grading.Study registrationIntegrated Research Application System project number 118959.Funding detailsThe National Institute for Health Research Health Technology Assessment programme.

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The economic burden of diabetic retinopathy in Germany in 2002

Abstract: This study is the first comprehensive study to provide estimates of costs associated with DR in Germany. These costs were estimated to account for approximately 1.5% of the total health-care expenditure in 2002.

Cited by 57 publications

References 14 publications

Prevalence and healthcare costs of diabetic retinopathy: a population-based register study in Sweden

Prevalence and healthcare costs of diabetic retinopathy: a population-based register study in Sweden

Diabetic retinopathy and health-related quality of life

Development of a cost-effectiveness model for optimisation of the screening interval in diabetic retinopathy screening

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