Cost-Benefit Analysis for Universal Cataract Coverage in India

AbstractPurposeTo calculate the annual enhanced coverage costs for covering the total and unmet need of cataract in India. To calculate the economic benefits of cataract burden averted. To calculate the net benefits of covering cataract needs.SettingWe look at population-level data of India and its 30 states.DesignThis is a retrospective cross-sectional analysis for 2018-19.MethodsWe conducted a retrospective cross-sectional analysis for India and its 30 states. Data was taken from Global Burden of Disease 2019, the National Health Profile 2020, and the National Health Accounts 2021. We used ten per-capita surgical costs to calculate enhanced coverage costs. Enhanced coverage costs for the total need were calculated by multiplying prevalence with per-capita costs. For unmet need, the difference between the prevalence and surgeries achieved was used. For economic benefits of averted cataract burden, we multiplied disability-adjusted life-years (DALYs) with non-health GDP per capita, i.e., GDP - the government health expenditure. DALYs for unmet needs were calculated by multiplying DALYs with the ratio of unmet to total needs. For net benefits, we subtracted the enhanced coverage costs for meeting total and unmet needs from economic benefits.ResultsThe annual enhanced coverage costs for covering total cataract needs in India were 0.92 - 4.9 billion USD. Costs for covering unmet needs were 0.72 - 3.82 billion USD. Nationally, the economic benefit of averting the total cataract disease burden was 12.4 (95%UI: 8.9 - 16.7) billion USD, while the for covering the unmet burden was 9.7 (95%UI: 6.93 - 13) billion USD. Annual net benefits of covering total needs were 7.53 - 11.5 billion USD. Net benefits of covering unmet needs were 5.9 - 9 billion USD.ConclusionEnhancing coverage for cataract is cost-beneficial.