Understanding the Clinical and Economic Burden of Diabetes-Related Eye Diseases

Kenneth J. Snow, MD, MBA: Diabetic eye disease is a significant burden. We know that there are over 30 million people in the United States with diabetes, and many of them will develop some form of diabetic eye disease, whether it’s diabetic retinopathy or diabetic macular edema. When this [eye disease] becomes sight threatening, it can really become a significant burden for our members and, of course, for our patients with diabetes.

In terms of the impact of diabetic eye disease on cost of care for diabetes, we know this is a very expensive complication. First, we have the cost of caring for the member directly—the cost of medical care. Then, there’s the secondary cost, which is lost productivity and, taken to its extreme, if somebody goes blind, the cost that goes with caring for somebody once they have lost their sight. The cost to the United States is estimated to run possibly as high as $500 million a year. This is a significant financial burden on society.

Diabetic eye disease really provides an opportunity for a disease state to be impacted by medical care ahead of time. All too often, the medical system has to respond to significant problems if somebody develops a problem. They need their appendix out. Well, nobody goes and gets their appendix out beforehand. We wait until there’s a problem. But, with diabetic eye disease, because of screening, we know that we can identify this type of disease well before it becomes a problem, and make sure that it gets treated to hopefully prevent a significant problem to sight, and at the very least, minimize it. So, the major first step that can be involved in taking care of somebody with diabetes and to protect their eyes is to make sure that they’re getting screened.

Unfortunately, we also know that many people don’t take advantage of this opportunity. Roughly, depending on the population we look at, only about half of all folks with diabetes get screened every year. In some populations, that rate is even lower. On top of that, we know that there are many people, possibly a quarter of all folks with diabetes, that don’t even know they have diabetes. So, of course, they’re not being screened at all.