Association for Research in Vision and Ophthalmology
Association for Research in Vision and Ophthalmology
Source/Disclosures
Source:

Curran D, et al. Teleretinal diabetic retinopathy screening is cost saving in an accountable care organization. Presented at: Association for Research in Vision and Ophthalmology annual meeting; June 12, 2020 (virtual meeting).

Disclosures: Curran reports no relevant financial disclosures.
June 17, 2020
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Simulation-based study shows cost-effectiveness of teleretinal screening for DR

Source/Disclosures
Source:

Curran D, et al. Teleretinal diabetic retinopathy screening is cost saving in an accountable care organization. Presented at: Association for Research in Vision and Ophthalmology annual meeting; June 12, 2020 (virtual meeting).

Disclosures: Curran reports no relevant financial disclosures.
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Teleretinal screening for diabetic retinopathy might save costs and help preserve vision at the same level as annual live exams at an ophthalmologist’s office, according to a study.

“DR is the leading cause of blindness in working-age Americans. Annual dilated eye exams are recommended, but adherence to screening is relatively poor, even though it has long been shown that early detection and treatment is effective,” Delaney Curran, medical student at the University of Vermont, said at the virtual Association for Research in Vision and Ophthalmology meeting.

Curran infographic

Teleretinal screening (TRS) has been suggested as a way to improve screening adherence and reduce some of the costs of DR management. It uses non-mydriatic fundus photography, which can be used in primary care offices remotely, and studies have shown that this method is preferred by most patients.

The study aimed to test the hypothesis that annual teleretinal screening will be cost-effective compared with an annual live exam for DR management in an accountable care organization. This form of coordinated care is popular in Vermont and follows models with the triple aim of better patient experience of care, lower per capita costs and improved population health. Cost-effectiveness of teleretinal screening and live screening was compared using decision-tree analysis with the TreeAge Pro software. The disability weight (DW) of vision impairment and the 1-year direct medical costs, including anti-VEGF treatment, were considered.

“Including all potential outcomes and treatments, the average cost per person was $230 in the TRS intervention and $292 in the live screen intervention. On average, TRS was shown to save $62 compared to live screening and to be cost saving 98.4% of the time. The average DW outcome was 0.001 for both groups, indicating less than mild vision impairment, with TRS resulting in a lower DW 55.9% of the time,” Curran said.

The model only considered direct costs, to which indirect costs such as loss of work and transportation costs should be added.

“There are inherent limitations and assumptions involved in economic simulations. However, as stated in a common aphorism in statistics, all models are wrong, but some are useful,” Curran said. “Since most people screened do not have DR, it makes sense to screen with the least expensive tests. Teleretinal screening might be a responsible way of managing an increasingly expensive problem.”