Original articleCost-effectiveness of a National Telemedicine Diabetic Retinopathy Screening Program in Singapore
Section snippets
Singapore Integrated Diabetic Retinopathy Program
The SiDRP program provides “real-time” assessment of DR photographs by a centralized team of trained and accredited graders supported by a tele-ophthalmology information technology infrastructure. Under the SiDRP system, retinal images are captured in primary care settings and subsequently transmitted to an ocular imaging center via a secured, web-based tele-ophthalmology platform. The trained graders assess the severity of DR in these images and send the results back to the FPs in the primary
Results
Panel 1 of Table 2 shows the total costs, total effectiveness, and ICER of the SiDRP compared with the FP model from the societal perspective. Over a lifetime, a patient with diabetes incurs a total cost of S$2802 and S$2629 under the FP and SiDRP models, respectively. In other words, SiDRP generates a cost savings of S$173 per patient.
The total QALY gain from the SiDRP is almost the same as the FP model (i.e., 13.1129 vs. 13.1123 QALYs). The similar health benefits between the SiDRP and FP
Discussion
This study estimated the cost-effectiveness of a telemedicine technician-based DR screening program (SiDRP) compared with the existing model (assessment by FP) in primary care in Singapore. Base-case results indicated that SiDRP generates a cost savings of $173 per patient ($144 from the health system perspective) relative to the FP model while generating equal QALYs. Our results were robust to variations in a number of key parameters. Extrapolating these results to the current volume of
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Supplemental material is available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
The authors received funding from the Singapore Ministry of Health, Grant Reference AIC/RPDD/SIDRP/SERI/FY2013/0018 and AIC/HPD/FY2016/0912.
Author Contributions:
Conception and design: Nguyen, Wong, Lamoureux
Data collection: Wei, Wong, Lamoureux
Analysis and interpretation: Nguyen, Wei, Tapp, Mital, Ting, Wong, Tan, Laude, Tai, Tan, Finkelstein, Wong, Lamoureux
Obtained funding: Not applicable
Overall responsibility: Nguyen, Wei, Tapp, Mital, Ting, Wong, Tan, Laude, Tai, Tan, Finkelstein, Wong, Lamoureux
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Both authors T.Y.W. and E.L.L. contributed equally.