The economic impact of sight loss and blindness in the UK adult population

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Abstract

Background

To quantify the economic impact of sight loss and blindness in the United Kingdom (UK) population, including direct and indirect costs, and its burden on health.

Methods

Prevalence data on sight loss and blindness by condition, Census demographic data, data on indirect costs, and healthcare cost databases were used. Blindness was defined as best corrected visual acuity (BCVA) of < 6/60, and sight loss as BCVA < 6/12 to 6/60, in the better-seeing eye.

Results

Sight loss and blindness from age-related macular degeneration (AMD), cataract, diabetic retinopathy, glaucoma and under-corrected refractive error are estimated to affect 1.93 (1.58 to 2.31) million people in the UK. Direct health care system costs were £3.0 billion, with inpatient and day care costs comprising £735 million (24.6%) and outpatient costs comprising £771 million (25.8%). Indirect costs amounted to £5.65 (5.12 to 6.22) billion. The value of the loss of healthy life associated with sight loss and blindness was estimated to be £19.5 (15.9 to 23.3) billion or £7.2 (5.9 to 8.6) billion, depending on the set of disability weights used. For comparison with other published results using 2004 disability weights and the 2008 estimates, the total economic cost of sight loss and blindness was estimated to be £28.1 (24.0 to 32.5) billion in 2013. Using 2010 disability weights, the estimated economic cost of sight loss and blindness was estimated to be £15.8 (13.5 to 18.3) billion in 2013.

Conclusions

The large prevalence of sight loss and blindness in the UK population imposes significant costs on public funds, private expenditure, and health. Prevalence estimates relied on dated epidemiological studies and may not capture recent advances in treatment, highlighting the need for population-based studies that track the prevalence of sight-impairing eye conditions and treatment effects over time.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-2836-0) contains supplementary material, which is available to authorized users.

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Most cited references 33

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Causes and prevalence of visual impairment among adults in the United States.

Nathan Congdon, Benita J O'Colmain, Caroline C. W. Klaver … (2004)

To estimate the cause-specific prevalence and distribution of blindness and low vision in the United States by age, race/ethnicity, and gender, and to estimate the change in these prevalence figures over the next 20 years. Summary prevalence estimates of blindness (both according to the US definition of < or =6/60 [< or =20/200] best-corrected visual acuity in the better-seeing eye and the World Health Organization standard of < 6/120 [< 20/400]) and low vision (< 6/12 [< 20/40] best-corrected vision in the better-seeing eye) were prepared separately for black, Hispanic, and white persons in 5-year age intervals starting at 40 years. The estimated prevalences were based on recent population-based studies in the United States, Australia, and Europe. These estimates were applied to 2000 US Census data, and to projected US population figures for 2020, to estimate the number of Americans with visual impairment. Cause-specific prevalences of blindness and low vision were also estimated for the different racial/ethnic groups. Based on demographics from the 2000 US Census, an estimated 937 000 (0.78%) Americans older than 40 years were blind (US definition). An additional 2.4 million Americans (1.98%) had low vision. The leading cause of blindness among white persons was age-related macular degeneration (54.4% of the cases), while among black persons, cataract and glaucoma accounted for more than 60% of blindness. Cataract was the leading cause of low vision, responsible for approximately 50% of bilateral vision worse than 6/12 (20/40) among white, black, and Hispanic persons. The number of blind persons in the US is projected to increase by 70% to 1.6 million by 2020, with a similar rise projected for low vision. Blindness or low vision affects approximately 1 in 28 Americans older than 40 years. The specific causes of visual impairment, and especially blindness, vary greatly by race/ethnicity. The prevalence of visual disabilities will increase markedly during the next 20 years, owing largely to the aging of the US population.

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The prevalence of refractive errors among adults in the United States, Western Europe, and Australia.

John H Kempen, Paul Mitchell, M Arfan Ikram … (2004)

To estimate the prevalence of refractive errors in persons 40 years and older. Counts of persons with phakic eyes with and without spherical equivalent refractive error in the worse eye of +3 diopters (D) or greater, -1 D or less, and -5 D or less were obtained from population-based eye surveys in strata of gender, race/ethnicity, and 5-year age intervals. Pooled age-, gender-, and race/ethnicity-specific rates for each refractive error were applied to the corresponding stratum-specific US, Western European, and Australian populations (years 2000 and projected 2020). Six studies provided data from 29 281 persons. In the US, Western European, and Australian year 2000 populations 40 years or older, the estimated crude prevalence for hyperopia of +3 D or greater was 9.9%, 11.6%, and 5.8%, respectively (11.8 million, 21.6 million, and 0.47 million persons). For myopia of -1 D or less, the estimated crude prevalence was 25.4%, 26.6%, and 16.4% (30.4 million, 49.6 million, and 1.3 million persons), respectively, of whom 4.5%, 4.6%, and 2.8% (5.3 million, 8.5 million, and 0.23 million persons), respectively, had myopia of -5 D or less. Projected prevalence rates in 2020 were similar. Refractive errors affect approximately one third of persons 40 years or older in the United States and Western Europe, and one fifth of Australians in this age group.

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Cost-of-illness studies: a guide to critical evaluation.

Allison Larg, John Moss (2011)

Cost-of-illness (COI) studies aim to assess the economic burden of health problems on the population overall, and they are conducted for an ever widening range of health conditions and geographical settings. While they attract much interest from public health advocates and healthcare policy makers, inconsistencies in the way in which they are conducted and a lack of transparency in reporting have made interpretation difficult, and have ostensibly limited their usefulness. Yet there is surprisingly little in the literature to assist the non-expert in critically evaluating these studies. This article aims to provide non-expert readers with a straightforward guide to understanding and evaluating traditional COI studies. The intention is to equip a general audience with an understanding of the most important issues that influence the validity of a COI study, and the ability to recognize the most common limitations in such work.

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Author and article information

Contributors

Lynne Pezzullo: lpezzullo@deloitte.com.au

Jared Streatfeild:

ORCID: http://orcid.org/0000-0003-4581-844X

+612 6263 7000 , jstreatfeild@deloitte.com.au

Philippa Simkiss: philippa.simkiss@rnib.org.uk

Darren Shickle: d.shickle@leeds.ac.uk

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 30 January 2018

Publication date PMC-release: 30 January 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 63

Affiliations

[1 ]Deloitte Access Economics Pty Ltd, 8 Brindabella Circuit, Canberra Airport, 2609 ACT Australia

[2 ]ISNI 0000 0001 0449 1108, GRID grid.421642.7, Royal National Institute of Blind People, ; London, UK

[3 ]ISNI 0000 0004 1936 8403, GRID grid.9909.9, Leeds Institute of Health Sciences, , University of Leeds, ; London, UK

Author information

Jared Streatfeild http://orcid.org/0000-0003-4581-844X

Article

Publisher ID: 2836

DOI: 10.1186/s12913-018-2836-0

PMC ID: 5791217

PubMed ID: 29382329

SO-VID: a0f701c5-706b-4cfd-a4e2-f5770119aefc

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 20 March 2016

Date accepted : 11 January 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100009010, Novartis Pharmaceuticals UK Limited;

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: sight loss,blindness,visual impairment,cost-of-illness,health economics,cost analysis,united kingdom

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ScienceOpen disciplines: Health & Social care

Keywords: sight loss, blindness, visual impairment, cost-of-illness, health economics, cost analysis, united kingdom

The economic impact of sight loss and blindness in the UK adult population

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Most cited references 33

Causes and prevalence of visual impairment among adults in the United States.

The prevalence of refractive errors among adults in the United States, Western Europe, and Australia.

Cost-of-illness studies: a guide to critical evaluation.

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