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Clinical science
The estimated healthcare cost of diabetic retinopathy in Indonesia and its projection for 2025
  1. Muhammad Bayu Sasongko1,
  2. Firman Setya Wardhana1,
  3. Gandhi Anandika Febryanto1,
  4. Angela Nurini Agni1,
  5. Supanji Supanji1,
  6. Sarah Rizqia Indrayanti1,
  7. Tri Wahyu Widayanti1,
  8. Felicia Widyaputri1,
  9. Idhayu Anggit Widhasari1,
  10. Yeni Dwi Lestari2,
  11. Gitalisa Andayani Adriono2,
  12. Iwan Sovani3,
  13. Arief Sjamsulaksan Kartasasmita3
  1. 1 Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada—Dr Sardjito General Hospital, Yogyakarta, Indonesia
  2. 2 Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia—Dr Ciptomangunkusumo National Hospital, Jakarta, Indonesia
  3. 3 Department of Ophthalmology, Faculty of Medicine, Universitas Padjajaran—Cicendo National Eye Hospital, Bandung, Indonesia
  1. Correspondence to Dr Muhammad Bayu Sasongko, Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada—Dr Sardjito General Hospital, Yogyakarta, Indonesia; mb.sasongko{at}ugm.ac.id

Abstract

Purpose To estimate the total healthcare cost associated with diabetic retinopathy (DR) in type 2 diabetes in Indonesia and its projection for 2025.

Methods A prevalence-based cost-of-illness model was constructed from previous population-based DR study. Projection for 2025 was derived from estimated diabetes population in 2025. Direct treatment costs of DR were estimated from the perspective of healthcare. Patient perspective costs were obtained from thorough interview including only transportation cost and lost of working days related to treatment. We developed four cost-of-illness models according to DR severity level, DR without necessary treatment, needing laser treatment, laser +intravitreal (IVT) injection and laser + IVT +vitrectomy. All costs were estimated in 2017 US$.

Results The healthcare costs of DR in Indonesia were estimated to be $2.4 billion in 2017 and $8.9 billion in 2025. The total cost in 2017 consisted of the cost for no DR and mild–moderate non-proliferative DR (NPDR) requiring eye screening ($25.9 million), severe NPDR or proliferative DR (PDR) requiring laser treatment ($0.25 billion), severe NPDR or PDR requiring both laser and IVT injection ($1.75 billion) and advance level of PDR requiring vitrectomy ($0.44 billion).

Conclusions The estimated healthcare cost of DR in Indonesia in 2017 was considerably high, nearly 2% of the 2017 national state budget, and projected to increase significantly to more than threefold in 2025. The highest cost may incur for DR requiring both laser and IVT injection. Therefore, public health intervention to delay or prevent severe DR may substantially reduce the healthcare cost of DR in Indonesia.

  • diabetic retinopathy
  • healthcare cost
  • financial burden
  • economic analysis

https://doi.org/10.1136/bjophthalmol-2019-313997

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    Footnotes

    • Contributors MBS contributed to data acquisition and analysis, and manuscript writing. FW critically reviewed and edited the manuscript. GAF performed partial data analysis and reviewed the draft of the manuscript. ANA critically reviewed and edited the manuscript. Supanji critically reviewed and edited the manuscript. SRD contributed to data collection, data management and drafting the manuscript. TWW reviewed and edited the manuscript. FSW reviewed and edited the manuscript. IAW contributed to data collection, data management and drafting the manuscript. YDL reviewed and edited the manuscript. GAA reviewed and edited the manuscript. IS critically reviewed and edited the manuscript. ASK critically reviewed and edited the manuscript.

    • Funding This study received funding from the Ministry of Research and Higher Education Research Grant, Government of Indonesia.

    • 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 or uploaded as supplementary information.

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