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Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea.
J Korean Med Sci. 2015 Dec; 30(12):1723-32.JK

Abstract

This study involved a cost-utility analysis of early diagnosis and treatment of diabetic retinopathy depending on the screening strategy used. The four screening strategies evaluated were no screening, opportunistic examination, systematic fundus photography, and systematic examination by an ophthalmologists. Each strategy was evaluated in 10,000 adults aged 40 yr with newly diagnosed diabetes mellitus (hypothetical cohort). The cost of each strategy was estimated in the perspective of both payer and health care system. The utility was estimated using quality-adjusted life years (QALY). Incremental Cost Effectiveness Ratio (ICER) for the different screening strategies was analyzed. After exclusion of the weakly dominating opportunistic strategy, the ICER of systematic photography was 57,716,867 and that of systematic examination by ophthalmologists was 419,989,046 from the perspective of the healthcare system. According to the results, the systematic strategy is preferable to the opportunistic strategy from the perspective of both a payer and a healthcare system. Although systematic examination by ophthalmologists may have higher utility than systematic photography, it is associated with higher cost. The systematic photography is the best strategy in terms of cost-utility. However systematic examination by ophthalmologists can also be a suitable policy alternative, if the incremental cost is socially acceptable.

Authors+Show Affiliations

Department of Ophthalmology, National Police Hospital, Seoul, Korea.Department of Health Informatics and Management, College of Medicine, Chungbuk National University, Cheongju, Korea.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26713046

Citation

Kim, Sang-Won, and Gil-Won Kang. "Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea." Journal of Korean Medical Science, vol. 30, no. 12, 2015, pp. 1723-32.
Kim SW, Kang GW. Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea. J Korean Med Sci. 2015;30(12):1723-32.
Kim, S. W., & Kang, G. W. (2015). Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea. Journal of Korean Medical Science, 30(12), 1723-32. https://doi.org/10.3346/jkms.2015.30.12.1723
Kim SW, Kang GW. Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea. J Korean Med Sci. 2015;30(12):1723-32. PubMed PMID: 26713046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea. AU - Kim,Sang-Won, AU - Kang,Gil-Won, Y1 - 2015/11/30/ PY - 2015/05/22/received PY - 2015/09/01/accepted PY - 2015/12/30/entrez PY - 2015/12/30/pubmed PY - 2016/10/8/medline KW - Cost-utility Analysis KW - Diabetic Retinopathy KW - Markov Model KW - Quality-Adjusted Life Years (QALY) SP - 1723 EP - 32 JF - Journal of Korean medical science JO - J Korean Med Sci VL - 30 IS - 12 N2 - This study involved a cost-utility analysis of early diagnosis and treatment of diabetic retinopathy depending on the screening strategy used. The four screening strategies evaluated were no screening, opportunistic examination, systematic fundus photography, and systematic examination by an ophthalmologists. Each strategy was evaluated in 10,000 adults aged 40 yr with newly diagnosed diabetes mellitus (hypothetical cohort). The cost of each strategy was estimated in the perspective of both payer and health care system. The utility was estimated using quality-adjusted life years (QALY). Incremental Cost Effectiveness Ratio (ICER) for the different screening strategies was analyzed. After exclusion of the weakly dominating opportunistic strategy, the ICER of systematic photography was 57,716,867 and that of systematic examination by ophthalmologists was 419,989,046 from the perspective of the healthcare system. According to the results, the systematic strategy is preferable to the opportunistic strategy from the perspective of both a payer and a healthcare system. Although systematic examination by ophthalmologists may have higher utility than systematic photography, it is associated with higher cost. The systematic photography is the best strategy in terms of cost-utility. However systematic examination by ophthalmologists can also be a suitable policy alternative, if the incremental cost is socially acceptable. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/26713046/Cost_Utility_Analysis_of_Screening_Strategies_for_Diabetic_Retinopathy_in_Korea_ L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2015.30.12.1723 DB - PRIME DP - Unbound Medicine ER -