PMD33 Estimating Societal Costs Associated with Vision Loss and Delayed Cataract Surgery: The Potential IMPACT of the COVID-19 Pandemic

ABSTRACT

Objectives: Cataract surgery is the most commonly performed surgical procedure in the EU (approx. 4 million annually). The suspension of interventions due to the COVID-19 pandemic, has had a devastating impact on patients’ access to care. For many countries, complete cessation of elective cataract surgery during the crisis has been an unfortunate reality. Patients on prolonged waiting lists may experience negative outcomes during the wait period, including vision loss, increased risk of falls, and ultimately, poorer health-related quality of life (HRQoL). The objective of this research was to estimate the potential societal costs associated with vision-loss related to expected prolonged waiting times for cataract surgery, as a consequence of COVID-19. Methods: In this analysis, we present estimates relating to 3 cohorts a hypothetical cohort of 1,000 cataract surgeries;quarterly estimates of cataract surgeries in the UK;quarterly estimates for the EU. Quarterly estimates were chosen to reflect a suspension of cataract surgeries for 3 months, during the COVID-19 crisis. UK and EU cataract surgery numbers were attained from EUROSTAT. Estimates for decreasing visual acuity for those waiting for surgery were attained from the literature, as were the cost-estimates associated with cataract-related sight-loss. 5 scenarios (at 20% intervals) were simulated for the cost-estimates, assuming from 20% to 100% clearing of waiting-lists. Results: For cohort 1 (1,000 patients), the societal-costs associated patients remaining on waiting list for one year, ranged between £326,831 (20% of patients remain untreated) to £1.63m (100% remain untreated). For cohorts 2(UK) & 3 (EU), cost estimates are £39.46m to £197.31m and €328.30m to €1.93 billion, respectively. Estimates consist of direct (13.35%), indirect (39.9%) and intangible costs (46.7%). Conclusions: Cataract surgery is a sight-saving procedure and its impact on HRQoL is overwhelmingly positive. The reduced access to care for cataract patients due to COVID-19 is likely to be associated with significant societal costs.