Economics of childhood Eye diseases and developing and testing of Quality of Life utility values

Abstract

India has a large population and thereby a lot of people with blindness and vision newlineimpairment specially amongst children. There have been a lot of eye health programs newlineimplemented to address blindness and vision impairment in India in the past two decades newlinewhich have reduced the burden of avoidable eye diseases significantly. This PhD work newlinehas aimed to study the economics of childhood eye diseases and thereby contribute to the newlineliterature the economic burden of blindness and vision impairment and estimate the QALY newlineutility values which can be used to undertake economic evaluations of eye care programs newlinein India. We have used secondary data to undertake the burden of disease study; and used newlineprospective longitudinal study design for comparison of change in utility values before and newlineafter intervention. We have used EQ-5D-Y health state valuation tool. Costs of interventions newlinewere calculated at prevailing rates. Sensitivity analyses were performed to account for newlineuncertainties in the data. Data analyses were performed using R application. The estimated newlinenet loss of GNI due to blindness in India is INR 845 billion (Int$ 38.4 billion). Net loss newlineof GNI due to blindness in children is INR 13 billion. The total cumulative loss of GNI newlinedue to blindness is INR 19,512 billion and cumulative loss due to avoidable blindness is newlineINR 11,778.6 billion. The average improvement of the utility values of vision impairment, newlineblindness, strabismus, pediatric cataract, and amblyopia was 0.15. The ICER for blindness newlineis INR 36,783 and pediatric cataract is INR 95,769. From the study, we have found that newlinethe interventions to address blindness and vision impairment are cost-effectiveness and are newlinelower than the willingness to pay of individuals in India. Early intervention of eye diseases newlinevi newlinein children significantly reduces the cumulative loss of GNI specially due to avoidable newlinecauses. The utility values estimated in this study contribute to the literature and help in newlineconducting economic evaluations of eye health programs and undertake informed