Grant: Travel Awards - Institute Community Support

Diabetic Retinopathy Screening Program in Toronto (DESP) is less costly and more effective in diagnosing Diabetic Retinopathy (DR) than standard screening among uninsured patients. Canadian DR screening practice falls behind recommended guidelines. Individuals who seek services at Ontario Community Health Centres (such as South Riverdale (SR) CHC) do not require health insurance (i.e. OHIP coverage) to receive care. We sought to evaluate monetary benefits associated with DESP screening and therapy in comparison with no screening/No Therapy option for DR for SRCHC uninsured patient. Data sources for costs were estimated for patients that sought DR screening at SRCHC between April 1, 2023, to March 31, 2024, combined with published literature and expert opinion. Monetary benefit was calculated by subtracting initial cost of investment from its final value (gain), then dividing this new number by cost of investment. Among N=827 patients by providing screening and treatment we may prevent DR progression to SVL in N=108 individuals (13%). Total annual cost of screening and treatment would be $183,531.90 (low-cost therapy); and $592,011.76 (high-cost therapy). The cost per SVL averted would be: $1,699.37 (low-cost therapy) and $5,481.59 (high-cost therapy). Annual cost with sight loss including loss of well-being would be $5,129,794.8 (per person $47,498.1). By providing screening and treatment, we would gain $4,946,262.9 (low-cost therapy) or $4,537,783.04 (high-cost therapy). We calculated ROI for Screening + low-cost therapy as $26.95 for $1 invested and for Screening + high-cost therapy as $7.66 for $1 invested. We found that the costs to implement the DR Screening Program at SRCHC alongside (provincial) coverage of subsequent therapy between 2023 and 2024 are outweighed by monetized value associated with benefits of screening and treatment, making a powerful case for the investment in DESP and therapy for uninsured patient populations.