Economics of Eye Care

Eye Care Economics Basics - Rupees & Retinas

• Opportunity Cost: Value of best alternative foregone in eye care resource allocation.
• Economic Evaluation Methods:
  • CEA (Cost-Effectiveness Analysis): $Cost/natural health outcome$ (e.g., vision year gained).
  • CUA (Cost-Utility Analysis): Uses QALYs/DALYs averted; $Cost/QALY$ or $Cost/DALY$.
  • CBA (Cost-Benefit Analysis): Costs & benefits in monetary terms. Benefit-Cost Ratio > 1 is good.
• Cost Categories in Eye Care:
  • Direct Costs: Medical (drugs, surgery), Non-medical (travel, attendant).
  • Indirect Costs: Productivity losses (visual impairment, treatment time).

⭐ DALY (Disability-Adjusted Life Year) = YLL (Years of Life Lost) + YLD (Years Lived with Disability). Key metric for overall disease burden.

Costing Eye Care - Counting the Costs

• Definition: Systematic identification, measurement, and valuation of resources consumed in eye care services.
• Key Cost Categories:
  • Direct Costs: Directly attributable to a specific patient or service (e.g., drugs, diagnostic tests, clinical staff salaries, equipment use).
  • Indirect Costs: Shared resources not directly tied to one patient (e.g., utilities, admin support, patient travel, lost productivity).
  • Intangible Costs: Non-monetary impacts (e.g., pain, suffering, ↓Quality of Life).
• Costing Perspectives: Determines included costs (patient, provider, payer, societal - broadest view, most comprehensive for public health).
• Common Costing Methods:

• Purpose: Essential for informed decision-making in budgeting, service pricing, operational efficiency improvement, and conducting economic evaluations (e.g., CEA, CUA).

⭐ Societal perspective is vital for eye care evaluations, capturing the full economic burden of visual impairment, including often substantial patient and family indirect costs.

Funding Vision India - Show Me The Money!

• Key Funding Streams in India:
  • Government (Public Sector): Central & State budgets.
    • National Programme for Control of Blindness & Visual Impairment (NPCBVI).
    • Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).
  • Private Sector:
    • Out-of-Pocket Expenditure (OOPE): Major component.
    • Private Health Insurance: Limited reach for comprehensive eye care.
  • Non-Governmental Organizations (NGOs): Crucial for service delivery, especially in underserved areas.
  • International Aid & Philanthropy.
• Core Challenges:
  • Inadequate public health spending on eye care.
  • High reliance on OOPE, leading to financial burden.
  • Uneven access to quality eye care services.

⭐ The NPCBVI aims to reduce the prevalence of blindness to 0.3% by 2025.

• Economic Considerations:
  • Cataract surgery is a highly cost-effective health intervention.

Blindness Burden & Benefits - Worth Every Rupee

• Economic Burden: Significant global issue.
  • Productivity loss, ↑ healthcare costs, ↓ Quality of Life (QoL).
  • High Disability-Adjusted Life Years (DALYs) burden.
• Benefits of Eye Care Investment: Highly cost-effective.
  • Cataract surgery: excellent cost-benefit ratio.
  • Restored vision → ↑ individual earnings, ↑ national productivity.
• India: National Programme for Control of Blindness & Visual Impairment (NPCBVI) emphasizes this.
  • Investing in eye care yields substantial socio-economic returns.

⭐ WHO estimates a 4:1 return on investment for every dollar spent on eye care in developing regions.

oka

High‑Yield Points - ⚡ Biggest Takeaways

• Cataract surgery is highly cost-effective, restoring sight and productivity.
• NPCBVI focuses on reducing avoidable blindness via government-funded schemes.
• Vision 2020 targeted disease control, HR development, and infrastructure.
• Interventions reduce DALYs, improving quality of life and economic output.
• High OOPE (Out-Of-Pocket Expenditure) is a key barrier to eye care access.
• Uncorrected refractive errors lead to significant productivity loss.
• Early screening for diseases like diabetic retinopathy is economically beneficial.