The Economic Model of Retinopathy of Prematurity (EcROP) Screening and Therapy in Mexico and the United States

Abstract

 

Purpose

 

The third epidemic of retinopathy of prematurity (ROP) has profound implications for infant blindness in middle-income countries. Survival rates of very low birth weight infants are improving. EcROP is a cost benefit economic model of ROP screening and treatment that includes both direct and indirect costs. EcROP was applied in the US (state of Georgia) and Mexico, a middle-income country.

 

Methods

 

Individual surveys were administered to the parents of blind children at eye clinics and schools for the blind in Mexico (n=43) and the US (n=52). included expenditures on labor, equipment, screening supplies. estimated the lost productivity of the caretaker(s). Costs were extrapolated over a lifetime using published economic statistics for both countries and rates of prematurity. Based on the natural history of ROP, we calculated a cost savings per neonate resulting from effective screening and treatment. The natural history and treatment were derived from the control arms of the Cryo-ROP and ET-ROP data respectively. For each country, the * costs were calculated, followed by lifetime cost.

 

Results

 

(See Table) Given the natural history of ROP, we calculated that the was $413,869 in Mexico and $949,261 in the US. The cost per QALY gained by ROP screening and treatment was highly cost effective, one of the best in medicine. Extrapolated financial data is highly impactful on a socio-economic basis and is estimated on incidence rates.

 

Conclusions

 

Effective screening and treatment of ROP ranks as one of the highest cost-benefit profiles of any treatments in medicine. The EcROP model is applicable to any region or country. The advantage of the model is that it accounts for equipment and labor expenditures, rather than based on insurance re-imbursement rates. This data is useful for healthcare policy when making key decisions for utilizing limited resources.  

 

Summary of Results