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Cost-Effectiveness of Addressing Retinopathy of Prematurity in Rwanda
Connor J Alder1, Francis Mutangana2, Victoria Phillips3
1College of Life Sciences, Brigham Young University, Provo, Utah, USA.
Insights
Implementing retinopathy of prematurity (ROP) screening and anti-VEGF treatment in Rwanda is cost-saving. This national program prevents infant blindness and reduces societal costs associated with vision loss.
Area of Science:
- Ophthalmology
- Public Health
- Health Economics
Background:
- Neonatal care expansion in sub-Saharan Africa increases the risk of retinopathy of prematurity (ROP) in premature infants.
- Few studies have assessed ROP cost-effectiveness in sub-Saharan Africa (SSA).
Purpose of the Study:
- To estimate the cost-effectiveness of a national ROP screening and anti-VEGF treatment program in Rwanda.
- To compare the proposed program costs against the status quo and societal burden of vision loss.
Main Methods:
- Medical costs were gathered from King Faisal Hospital, Rwanda.
- Societal burden included lost productivity and quality-adjusted life years (QALYs).
- A decision analysis model compared a national program's cost to the status quo for a one-year birth cohort.
Main Results:
- ROP screening and treatment cost $738 per infant, with initial equipment costs of $58,667.
- A national program could prevent 257 cases of infant blindness and increase QALYs.
- An estimated $270,000 could be saved per birth cohort due to reduced lost productivity.
Conclusions:
- The cost of ROP screening and anti-VEGF treatment is significantly lower than the indirect costs of vision loss.
- Expanding ROP screening and treatment programs is a cost-saving measure from a societal viewpoint compared to current practices.
Purpose:
With the expansion of neonatal care in sub-Saharan Africa (SSA), an increasing number of premature babies are at risk to develop retinopathy of prematurity (ROP). Previous studies have quantified the cost-effectiveness of addressing ROP in middle-income countries, but few have focused on SSA. This study estimates the cost of a national program for ROP screening and anti-VEGF injection treatment in Rwanda compared to the status quo.
Methods:
Medical cost data were collected from King Faisal Hospital in Rwanda (July 2022). Societal burden of vision loss included lost productivity and quality-adjusted life years (QALYs). Published data on epidemiology and natural history of ROP were used to estimate burden and sequelae of ROP in Rwanda. Cost of a national program for screening and treating a one-year birth cohort was compared to the status quo using a decision analysis model.
Results:
Cost of ROP screening and treatment was $738 per infant. The estimated equipment cost necessary for the startup of a national program was $58,667. We projected that a national program could avert 257 cases of blindness in the cohort and increase QALYs compared to the status quo. Screening and treatment for ROP would save an estimated $270,000 for the birth cohort from reductions in lost productivity.
Conclusion:
The cost of screening and anti-VEGF treatment for ROP is substantially less than the indirect cost of vision loss due to ROP. Allocating additional funding towards expansion of ROP screening and treatment is cost-saving from a societal perspective compared to current practice.
