Table 3.
Cost-effectiveness analysis of applying AI in DR screening in primary care settings in 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 | 647,551 | 648,219 | 655,751 | 657,350 | 669 | 8,200 | 9,800 |
| Total cost (AU$, million) | 796.0 | 787.7 | 778.4 | 776.7 | −8.3 | −17.6 | −19.2 |
| Screening cost | 6.7 | 1.1 | 3.5 | 4.2 | −5.6 | −3.2 | −2.5 |
| Link to care cost | 0.0 | 0.0 | 5.7 | 7.7 | 0.0 | 5.7 | 7.7 |
| Direct medical cost | 101.7 | 116.8 | 251.2 | 276.1 | 15.1 | 149.5 | 174.4 |
| Consultation cost | 10.4 | 13.1 | 30.5 | 33.8 | 2.7 | 20.1 | 23.4 |
| Fluorescein angiography cost | 2.9 | 3.4 | 7.4 | 8.1 | 0.5 | 4.5 | 5.2 |
| OCT cost | 2.6 | 3.0 | 6.5 | 7.1 | 0.4 | 3.9 | 4.5 |
| Photocoagulation cost | 18.5 | 21.6 | 47.6 | 52.3 | 3.1 | 29.1 | 33.8 |
| Anti-VEGF injection cost | 65.6 | 75.7 | 159.2 | 174.8 | 10.1 | 93.6 | 109.2 |
| Vitrectomy cost | 1.7 | 2.0 | 4.2 | 4.6 | 0.3 | 2.5 | 2.9 |
| Cost for blindness care | 687.6 | 669.9 | 518.1 | 488.8 | −17.7 | −169.5 | −198.8 |
| VTDR detected (cases) | 5,010 | 5,932 | 11,846 | 12,522 | 922 | 6,836 | 7,512 |
| Blindness (cases) | 3,396 | 3,260 | 2,313 | 2,185 | −136 | −1,083 | −1,211 |
| ICER | – | – | – | – | −12,360 (Dominating) | −2,143 (Dominating) | −1,964 (Dominating) |
| Incremental cost/blindness averted (AU$) | – | – | – | – | −60,837 (Dominating) | −16,232 (Dominating) | −15,890 (Dominating) |
| Benefit-cost ratioa | – | – | – | – | 7.70 | 1.91 | 1.62 |
| NMB (AU$, million)b | – | – | – | – | 42 | 428 | 509 |
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.