Deloitte Access Economics’ Optometry Workforce Report, commissioned by Specsavers, assessed the potential effectiveness of two optometrical interventions in addressing the two main forms of visual impairment:
A cost benefit analysis of increasing per capita ratios of optometrists in country areas to those of cities
The first scenario looked at the potential benefits in eye health outcomes to having a gradual increase of more optometrists being placed in regional areas. Deloitte Access Economics estimated that each person with vision impairment in 2018 would cost $15,285, while the overall cost of placing an additional optometrist in a country area was estimated at $327,000 per year. Therefore, if achieving parity was able to reduce the number of cases of under-corrected refractive error by 110 per optometrist, the result in benefits would be $1.68 million per optometrist – a benefit to cost ratio of 5.1 to 1.
A benefits realisation analysis of a nation-wide roll out of a fast and efficient program to detect glaucoma, macular degeneration and diabetic retinopathy by Specsavers
The second scenario analysed Specsavers’ nationwide rollout of OCT and systematic use as part of every routine eye test to screen for glaucoma, macular degeneration and diabetic retinopathy.
The report measured the cost of the machine against the substantial benefit of detecting eye conditions before they cause vision impairment. Even though OCT has a sensitivity rate of 80%-100%, it is not just the accuracy of the device that determines the impact of screening programs in reducing visual impairment. It is also the skill of the operator and the optometrist interpreting the results, and the likelihood of the patient to attend a follow up referral with an ophthalmologist.
Therefore, the expected value per screen was adjusted by 50% for ‘real world’ factor to between $193 for glaucoma and $360 for diabetic retinopathy. As a result, the report concluded that from a societal viewpoint, the benefit to cost ratio of an OCT within a comprehensive eye test, on a prevalence-weighted average, is 4.65 to 1.
On top of this, the lifetime disease cost for glaucoma is greater than the cost of an OCT machine, and for macular degeneration and diabetic retinopathy both more than half that cost. Considering this, the report concluded that it would only require an OCT machine to successfully identify one or two cases of glaucoma, macular degeneration or diabetic retinopathy to pay for itself from a societal point of view in terms of prevented vision impairment.