Table 2.
Cost-effectiveness analysis of applying AI in DR screening in primary care settings in non-Indigenous diabetic patients over a time horizon of 40 years.
| Status quo | Scenario A | Scenario B | Scenario C | Incremental cost or effectiveness (Scenario A) | Incremental cost or effectiveness (Scenario B) | Incremental cost or effectiveness (Scenario C) | |
|---|---|---|---|---|---|---|---|
| QALY | 15,102,882 | 15,119,359 | 15,250,035 | 15,274,972 | 16,477 | 147,154 | 172,090 |
| Total cost (AU$, million) | 13,039.6 | 12,860.0 | 12,510.6 | 12,443.8 | −179.6 | −529.0 | −595.8 |
| Screening cost | 139.8 | 24.3 | 58.5 | 67.0 | −115.4 | −81.3 | −72.8 |
| Link to care cost | 0.0 | 0.0 | 62.9 | 83.5 | 0.0 | 62.9 | 83.5 |
| Direct medical cost | 2,875.0 | 3,344.8 | 5,861.0 | 6,220.1 | 469.8 | 2985.9 | 3345.0 |
| Consultation cost | 330.5 | 428.5 | 783.0 | 836.9 | 98.0 | 452.6 | 506.5 |
| Fluorescein angiography cost | 92.4 | 107.9 | 188.9 | 200.1 | 15.5 | 96.6 | 107.7 |
| OCT cost | 81.0 | 94.5 | 165.6 | 175.4 | 13.6 | 84.6 | 94.4 |
| Photocoagulation cost | 639.0 | 746.3 | 1,308.4 | 1,384.3 | 107.3 | 669.4 | 745.4 |
| Anti-VEGF injection cost | 1,687.6 | 1,967.7 | 3,415.0 | 3,623.3 | 280.1 | 1,727.5 | 1,935.7 |
| Vitrectomy cost | 44.7 | 52.1 | 90.4 | 95.9 | 7.4 | 45.7 | 51.2 |
| Cost for blindness care | 10,024.8 | 9,490.8 | 6,528.2 | 6,073.2 | −533.9 | −3,496.6 | −3,951.6 |
| VTDR detected (cases) | 304,865 | 348,186 | 509,209 | 521,692 | 43,321 | 204,344 | 216,827 |
| Blindness (cases) | 96,269 | 89,645 | 60,884 | 57,922 | −6,624 | −35,385 | −38,347 |
| ICER | – | – | – | – | −10,897 (Dominating) | −3,595 (Dominating) | −3,462 (Dominating) |
| Incremental cost/blindness averted (AU$) | – | – | – | – | −27,108 (Dominating) | −14,950 (Dominjating) | −15,537 (Dominating) |
| Benefit-cost ratioa | – | – | – | – | 7.37 | 4.36 | 3.96 |
| NMB (AU$, million)b | – | – | – | – | 1,003 | 7,887 | 9,200 |
a
Benefit-cost ratio is calculated as the total cost savings divided by the sum of screening costs and link-to-care costs.
b
NMB, net monetary benefit is calculated as the QALYs gained multiplied by willingness-to-pay minus total incremental costs.