Cost-effectiveness of detecting and treating diabetic retinopathy

Jonathan C. Javitt, Lloyd Paul Aiello

Research output: Contribution to journalArticlepeer-review


Objective: To determine, from the health insurer's perspective, the cost of preventing vision loss in patients with diabetes mellitus through ophthalmologic screening and treatment and to calculate the cost- effectiveness of these interventions as compared with that of other medical interventions. Design: Computer modeling, incorporating data from population- based epidemiologic studies and multicenter clinical trials, Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings. Results: Screening and treatment of eye disease in patients with diabetes mellitus costs $3190 per quality-adjusted life year (QALY) saved. This average cost is a weighted average (based on prevalence of disease) of the cost effectiveness of detecting and treating diabetic eye disease in those with insulin-dependent diabetes mellitus ($1996 per QALY), those with non-insulin-dependent diabetes mellitus (NIDDM) who use insulin for glycemic control ($2933 per QALY), and those with NIDDM who do not use insulin for glycemic control ($3530 per QALY). Conclusions: Our analysis indicates that prevention programs aimed at improving eye care for diabetic persons not only result in substantial federal budgetary savings but are highly cost-effective health investments for society. Ophthalmologic screening for diabetic persons is more cost-effective than many routinely provided health interventions. Because diabetic eye disease is the leading cause of new cases of blindness among working-age Americans, these results support the widespread use of screening and treatment for diabetic eye disease.

Original languageEnglish (US)
Pages (from-to)164-169
Number of pages6
JournalAnnals of Internal Medicine
Issue number1 II
StatePublished - Jan 1 1996
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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