The societal burden of blindness secondary to retinopathy of prematurity in Lima, Peru

Purpose: To determine the cost-effectiveness of laser treatment for retinopathy of prematurity (ROP) in Lima, Peru. Design: A cost-of-illness study (in US dollars) to determine the direct cost of treatment, the indirect lifetime cost of blindness, and the quality-adjusted life years. Methods: The direct cost of ROP-related treatment was determined by reviewing data retrospectively from a social security sector hospital. The indirect cost was determined using national economic data of Peru published by the Central Information Agency (CIA), including the per capita gross domestic product, the sex-adjusted income distribution, and years spent in the work force. Indirect costs per child that were avoided by treatment were calculated using the known natural history of ROP vs evidence-based treatment. Results: For ROP-related neonatal blindness in Peru, we estimate the total indirect cost saving at $197 753 per child and the direct cost of laser treatment at $2496 per child. The societal lifetime cost saving per child is estimated at $195 257. The mean annual income per educated adult in Peru is $8000 and treating 1 child is equivalent to employing 24 educated Peruvians per year. The generational cost savings for society is approximately $516 million, or the equivalent of 64 500 educated Peruvian work years. Conclusions: The societal burden of blindness far exceeds the costs of treatment per child. Proper screening and treatment of ROP prevents blindness and leads to substantial cost savings for society. Public health policy in Peru and other middle-income countries should consider financial impact when allocating healthcare resources.