Costs and cost-effectiveness of the Kerala pilot screening programme for diabetic retinopathy in the public health system
Wittenberg R., Anderson R., Redding S., Gopal B., Sadanandan R., Sahasranamam VI., George S., Premnazir L., Netuveli G., Srinath J., Ramakrishnan R., Conroy D., Sivaprasad S.
Abstract Background/objectives The Government of Kerala initiated a pilot screening programme for diabetic retinopathy in 16 Family Health Centres in Thiruvananthapuram district in 2019 in collaboration with the ORNATE India project. The evaluation of this pilot included a study of its costs and cost-effectiveness to inform decisions about extending the programme throughout Kerala. Subjects/methods The participants comprise all 5307 people who were screened for diabetic retinopathy under the pilot programme for whom data could be collected. Results The costs of the pilot programme are estimated at INR 11.3 million (including INR 1.9 million costs to individuals) and the benefits at 514 QALYs, slightly over one QALY per person treated. The cost per QALY was INR 22,000, which is well below India’s Gross National Income per person. Conclusions Kerala’s 2019 pilot screening programme for diabetic retinopathy was highly cost-effective.