Cost analysis of a virtual retina clinic versus fully face-to-face clinics

Virtual clinics represent an innovative approach to the management of chronic diseases, particularly in ophthalmology, by optimizing resource allocation and alleviating the burden on traditional face-to-face (F2F) services. Despite their growing implementation, there is a lack of comprehensive studies assessing their efficiency. This study aims to compare the cost-effectiveness of the Virtual Retina Clinic (VRC) with F2F clinics in the follow-up of stable retinal diseases.

A cost-minimization analysis (AMC) was conducted by measuring resource utilization of patients in conventional F2F visits in 2019, and through the VRC in 2020. Our previous study on the VRC effectiveness demonstrated the equivalence of the results of the VRC and F2F approaches, as required for AMC, and a VRC sensitivity of 100% for detecting progression. The unit costs were obtained from the hospital´s accounting system. Furthermore, indirect costs related to labor productivity losses in patients and their companions were analyzed.

No significant differences were found between the total direct direct costs of the VRC and conventional clinics in the follow-up of 481 patients with stable retinal diseases. The differences detected were that VRC staff costs were significantly lower (54.5% vs. 76.8% for F2F clinics) while its equipment costs were higher (32.8% vs. 10%). Overall, including the costs of productivity losses, the VRC is significantly less expensive than in-person care as it more than halves indirect costs.

This first study analyzing the costs of a VRC versus fully F2F clinics found that it is not more expensive for the follow-up of stable retinal diseases. Additionally, taking into account indirect costs, the VRC is less expensive, and once the equipment has been acquired, its costs are lower than those of conventional clinics.