The Cost of Visual Impairment: Purposes, Perspectives and Guidance
Kevin D. Frick, PhD
Association for Research in Vision and Ophthalmology (ARVO)
This paper outlines the first collaboratively developed process and best practices for measuring the burden of vision loss.
Recommendations for calculating costs include listing out monetary expenditures on health care (hospital, outpatient, and other), monetary expenditures on things other than health care, loss of patient productivity, loss of family member productivity, deadweight losses, and loss of patient well-being.
The paper suggests that the process developed can be added to, as well as adjusted for other conditions.
In recent years, there have been numerous attempts to quantify the costs associated with vision impairment in specific countries and around the world. Analysts have used different approaches, making it difficult to draw general conclusions or compare studies. Over the past 15 years, numerous guidelines or standards for cost-related analyses have been set forth. Given the desirability of standardization, the Vancouver Economic Burden of Vision Loss Group was convened to standardize methods for burden-of-disease calculations for vision loss. The meeting included presentations of papers published before the meeting and discussion of the options for analytical approaches.
This article reflects the results of the first collaborative effort to discuss guidelines for burden-of-disease calculations in vision research. The objectives are (1) to delineate the difference between incidence- and prevalence-based calculations; (2) to list different types of economic evaluations; and (3) to specify how the elements of costs included in the burden calculation depend on the type of economic evaluation (i.e., cost-effectiveness or cost-benefit), the perspective of the analysis, and the point of initiation of the analysis (i.e., screening for vision loss, preventing vision loss, treating vision loss, or describing the lives of individuals who already have vision loss).
We conclude with several recommendations. Although a single set of standards would be useful, the context and requirements of the analysis dictate the manner and method of evaluation. Thus, recommendations will serve as guidelines rather than standards.