STRATEGIES TO SCREEN FOR DIABETIC RETINOPATHY IN CHINESE PATIENTS WITH NEWLY DIAGNOSED TYPE 2 DIABETES: A COST-EFFECTIVE ANALYSIS
Method(s): Different DR screening programs were modelled to project economic outcomes by using discrete-event simulation (DES)methods. Hypothetical patients based on the Chinese population from the China National Diabetes and Metabolic Disorders Study who were newly diagnosed with diabetes.To develop the economic model, we calibrated the progression rates of DR that fit Chinese epidemiologic data derived from the published literature. Costs were estimated from the perspective of the Chinese health care system, and the analysis was run over a lifetime horizon.Total costs, visual outcome, costs per quality-adjusted life year (QALY), the incremental cost-effectiveness ratio (ICER) of screening strategies over no screening. One-way and probabilistic sensitivity analyses were performed.
Result(s): DR screening is an effective in Chinese patients with newly diagnosed T2DM, and screen strategies with interval ≥4 year were cost-effective (ICER < $7,485 per QALY) compared with no screening. Screening every four years gained greatest QALYs (11.066) in the cost-effective strategies. The screening intervals could be varied dramatically by T2DM diagnosed age. Probabilistic sensitivity analyses demonstrated the consistency and robustness of the cost-effectiveness of the screening every four years strategy.
Conclusion(s): The findings suggest that a screening every four years strategy is likely to be more cost-effective than every 1-3 years screening strategies in comparison with no screening in Chinese setting. The screening intervals might be tailed according to the T2DM diagnosed age.