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Rapid assessment of avoidable blindness-based healthcare costs of diabetic retinopathy in Hungary and its projection for the year 2045
  1. Gábor Tóth1,2,
  2. Hans Limburg3,
  3. Dorottya Szabó1,
  4. Gábor L Sándor1,
  5. Zoltán Z Nagy1,
  6. János Németh1,2
  1. 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
  2. 2 The International Agency for the Prevention of Blindness, London, United Kingdom
  3. 3 Health Information Services, Grootebroek, Netherlands
  1. Correspondence to Gábor Tóth, FEBO, Department of Ophthalmology, Semmelweis University, Mária Utca 39, Budapest, Hungary; gabortothgabor{at}


Background/aims The purpose of this study was to estimate the total healthcare cost associated with diabetic retinopathy (DR) in the population aged 18 years and older in Hungary, and its projection for the year 2045.

Methods A cost model was developed based on the standardised rapid assessment of avoidable blindness with the diabetic retinopathy module (RAAB+DRM) methodology and recently reported prevalent-based cost of illness model. Projection for 2045 was made based on the estimation for increasing diabetes mellitus (DM) prevalence of the International Diabetes Federation. Costs were analysed from the perspective of the healthcare system and the patients. Our DR cost model was constructed according to the Scottish DR grading scale and based on the DR severity stadium.

Results The total DR-associated healthcare cost was US$145.8 million in 2016 and will increase to US$169.0 million by 2045. The two major cost drivers were intravitreal antivascular endothelial growth factor injections and vitrectomies in this study (US$126.4 million in 2016 and US$146.5 million in 2045); they amounted to 86.7% of the total treatment cost of DR. The DR-related cost per patient was US$180.5 in Hungary.

Conclusions The cost per patient for treating DR was lower in Hungary than in other countries. Due to the increasing socioeconomic burden of proliferative DR and diabetes-related blindness, it would be important to invest in DR screening, prevention and early treatment. Our new RAAB-based cost of DR model may facilitate comparisons of DR treatment costs across countries.

  • Epidemiology
  • Retina

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  • Contributors GT planned and designed the survey and wrote the manuscript. DS and GLS designed and conducted the survey. ZZN planned the survey and reviewed the manuscript. HL and JN designed the survey, edited and reviewed the manuscript. All authors agree with the final version of the manuscript and agree to be accountable for all aspects of the work.

  • Funding Dr Tóth reported grants from EFOP-3.6.3-VEKOP-16-2017-00009 grant. The funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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