Introduction
With the expansion of neonatal care in sub-Saharan Africa (SSA), an increasing number of premature babies are at risk of retinopathy of prematurity (ROP).¹ ̓² Many neonatal intensive care units in SSA are unable to provide adequate care for these infants due to problems such as nursing shortages and a lack of oxygen supplementation equipment. Previous studies have quantified the cost-effectiveness of addressing ROP in middle-income countries³, but few have focused on SSA. This study estimates the cost of ROP screening and anti-VEGF injection treatment in Rwanda compared to the economic burden of untreated ROP. Methods
Medical cost data were collected from King Faisal Hospital in Kigali, Rwanda during July 2022. The financial burden of blindness included the increased costs of education and lost income (with inflation adjustment). Published data on the epidemiology and natural history of ROP were used to estimate the annual burden and sequelae of ROP in Rwanda.¹ The country-level cost of screening and treating a one-year birth cohort was compared to the lifetime cost of not addressing ROP for the same cohort (US dollar). Results
The cost of ROP treatment is $736 per infant. The lifetime cost of blindness amounts to $200,339 per infant. The total country-level cost of screening and treating ROP for a one-year birth cohort is $2,084,122, with the burden of blindness despite adequate treatment being $29,650,172. Not treating the same cohort results in a lifetime cost of blindness of $69,918,311. Conclusion
The cost of anti-VEGF treatment for ROP is substantially less than the indirect cost of blindness due to ROP. Allocating additional funding towards expansion of ROP screening and treatment would be an effective means of reducing the economic burden of blindness due to ROP. References
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2. Herrod SK, Adio A, Isenberg SJ, Lambert SR. Blindness Secondary to Retinopathy of Prematurity in Sub-Saharan Africa. Ophthalmic Epidemiology. 2022 Mar 4;29(2):156-63.
3. Dave HB, Gordillo L, Yang Z, Zhang MS, Hubbard GB, Olsen TW. The Societal Burden of Blindness Secondary to Retinopathy of Prematurity in Lima, Peru. American Journal of Ophthalmology. 2012 Oct 1;154(4):750-5.