Original articleThe Cost–Utility of Telemedicine to Screen for Diabetic Retinopathy in India
Section snippets
Study Setting and Program Description
The study was undertaken in rural Tamil Nadu, Southern India. A recent survey in rural Tamil Nadu estimated the diabetes prevalence at 7.8% among people aged ≥20 years.16
The Sankara Nethralaya Medical Research Foundation teleophthalmology program conducts DR screening camps in villages in the rural districts neighboring Chennai. In the current program, 1-off screening (i.e., screening offered once) is conducted in each village rather than diabetic persons being invited for screening repeatedly
Model Parameters
Table 1 shows the per-person costs of telescreening, hospital retinal examinations, and laser photocoagulation treatment from the health provider and societal perspective. The health provider costs of telescreening were $7.36 per person screened, and the societal costs (i.e., including direct and indirect household costs) were $9.38. Costs for retinal examination and a single laser photocoagulation treatment at the hospital were $5.84 and $7.51 per person, respectively, from the health provider
Discussion
Our cost–utility model suggests that from a health provider perspective, the current Sankara Nethralaya rural teleophthalmology screening program is cost-effective compared with no DR screening for rural diabetic patients if the World Health Organization–suggested threshold (1–3 times the Indian GDP) is used to define cost-effectiveness.18, 19 Increasing the screening frequency to provide screening at regular intervals would increase the costs of the program; however, the increased QALYs gained
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Manuscript no. 2012-634.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
This study was funded by a grant from Sightsavers. The funding organization had no role in the design or conduct of this research.