The Economic Burden of Diabetic Retinopathy in Jordan: Cost Analysis and Associated Factors

Abstract

Objective

Diabetic retinopathy (DR) is the leading cause of visual loss worldwide in patients with diabetes mellitus (DM). The aims of our study are to describe the costs associated with (DR) and to evaluate its economic impact in Jordan.

Methods

Retrospectively, we included all patients with DM and classified them according to the severity of DR. Data regarding medical history, ophthalmic history, stage of DR, presence of DME, and the ophthalmic procedures and operations were collected. The total DR-related cost was measured as a direct medical cost for the outpatient and inpatient services.

Results

Two hundred and twenty-nine patients were included in the study. Only 49.7% of the patients presented without DR, and 21% presented with diabetic macular edema (DME) unilaterally or bilaterally. The DR-related cost was significantly associated with insulin-based regimens, longer duration of DM, higher HbA1c levels, worse stage of DR at presentation, the presence of DME at presentation, the presence of glaucoma, and increased mean number of intravitreal injections, laser sessions, and surgical operations. Multivariate analysis should the presenting stage of DR, presence of DME, and the presence of DME be the independent factors affecting the DR-related cost.

Conclusion

This study is the first study to be conducted in Jordan and encourages us to establish a screening program for DR for earlier detection and treatment. DM control and treatment compliance will reduce the heavy costs of the already exhausted healthcare and financial system.

Keywords:

• diabetic retinopathy
• economic burden
• intravitreal injections
• diabetic macular edema

Data Sharing Statement

The datasets generated and analyzed during the current study are available from the corresponding author.

Ethical Approval

This study has been performed in accordance with the 1964 Declaration of Helsinki and its later amendments. This study has obtained ethical approval from the IRB at Jordan University of Science and Technology and King Abdullah University Hospital, Irbid, Jordan (38/137/2021). The authors confirm that the patients’ privacy was saved, and the data was anonymized and kept confidential. The IRB waived the need for consent due to the study’s retrospective nature.

Disclosure

The authors have no conflicts of interest to disclose for this work.

Additional information

Funding

The authors have not declared any grant for this work from any funding authority.