Purpose:
To estimate the cost of blindness and visual impairment (VI) in Latin America using simple economic methods.
Methods:
Twelve countries were selected as representative of the region. Minimum wage and gross national income per capita (GNI, purchasing power parities method) for each country were obtained from Bracci and Bloomberg, and the World Bank respectively. Sources of prevalence of blindness/visual impairment data for individuals aged ≥ 50 y (all causes, except for diabetic retinopathy [DR], which used data for individuals aged ≥ 20 y) were published papers, rapid assessment of avoidable blindness studies, and the World Health Organization. Prevalence of DR was adjusted for prevalence of diabetes in each country. Costs of blindness/VI included cost of treating diabetes in each country per individual, but not cost of treating ophthalmic disease. Calculations took into account population size aged ≥ 50 y (≥ 20 y for DR), assumed that a blind person could not work (no adjustments for retirement), and that VI caused 30% loss of work productivity. Calculations assumed that 2/3 of ≥ 50 year-olds are economically active and that half of the blindness/visual impairment is allotted to the 50-64 years-old group.
Results:
Generally, the cost of VI exceeded the cost of blindness, with the biggest economic costs in Mexico and Brazil, followed by Argentina. Cost of blindness/VI from all causes was U.S.$7.4 billion using the minimum wage method, and U.S.$28.3 billion using the GNI method. DR represented 53% of the costs, largely because the disease strikes much earlier than other ophthalmic diseases in terms of age.
Conclusions:
Even if some assumptions about the average patient age with DR are relaxed, this disease is still likely to be the largest contributor to the cost of blindness/VI.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • visual acuity