Reducing Economic Burden of Diabetic Retinopathy Through Use of Telemedicine

The use of telemedicine technology could lower costs and reduce the overall economic burden of diabetic retinopathy (DR), according to a recent study published in Cost Effectiveness and Resource Allocation.

Daniel Avidor, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel, and colleagues, noted in their study that DR causes tremendous economic and public health burden across the globe, accounting for approximately 15% to 17% of all cases of total blindness.

In recent years, telemedicine has become a successful intervention for DR screening but few studies explore its cost-effectiveness. The researchers reviewed the newest literature regarding the economic evaluations of telemedicine for DR and then summarized the evidence.

"Diabetic retinopathy telemedicine technology has the potential to provide significant cost savings," explained the authors of the study, “especially in low-income populations and rural patients with high transportation costs.”

Existing study data from 2010 through 2020 sourced via PubMed, Embase, and Google Scholar was included in the researchers’ analysis if it met the following criteria:

• recruited subjects with either type 1, type 2 diabetes;
• evaluated telemedicine technology;
• patients underwent primary screening for DR;
• compared a telemedicine-based intervention with standard care; and
• performed an economic evaluation or provided sufficient data for evaluating the cost-effectiveness of the technology used.

Seven studies were included in the final evaluation and were conducted in the United States, Singapore, Canada (2), India, Brazil, and South Africa.

The assessed studies all “used a telemedicine program which included capturing a retinal image and subsequently transmitting it to an ocular imaging center to assess the severity of DR.” Each examined study also compared telemedicine to standard screening method including the option of no screening as standard of care.

“Although telemedicine requires initial and maintenance costs,” noted the researchers, “it has the potential to provide significant cost savings by increasing patients' working ability, increasing independent living ability, increasing quality of life and reducing travel costs.”

—Edan Stanley

Reference:

Avidor D, Loewenstein A, Waisbourd M, Nutman A. Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review. Cost Eff Resour Alloc. 2020;18:16. doi:10.1186/s12962-020-00211-1.