Cost-benefit analysis of screening for diabetic retinopathy among Chinese type 2 diabetes: Decision from different perspectives of a population-based study in Kinmen, Taiwan

Background: To explore whether it is worthwhile to launch a routine diabetic retinopathy(DR) screening for blindness prevention among Chinese type 2 diabetes from different perspective based on the population-based study in Kinmen, Taiwan.

Methods: A total of 971 community dwelling adults previously diagnosed with type 2 diabetes in 1991-1993 underwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect ophthalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening.

Results: DR screening could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in different screening years from the societal viewpoint and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The average estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 benefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years.Conclusions: It is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal perspective but not from consumer decision based on the willingness-to-pay perspective.