Cost and benefits of availing specialty contact lenses for irregular cornea and ocular surface diseases from patient perspectives.

Abstract

Purpose: To assess the cost of availing specialty contact lenses for irregular cornea and ocular surface diseases from the perspective of patients.

Methods: Patients aged ≥18 years who purchased specialty contact lenses (corneal or scleral) for the management of irregular corneal or ocular surface diseases between August 2023 and January 2024 were included in this study. Using a micro-costing approach, cost per patient was estimated with the help of the institution's records, and via a semi-structured survey. The benefit-cost ratio was calculated as the valuation of benefits in terms of gain in productivity resulting from the use of contact lenses to the cost. Quality of life was measured using "The National Eye Institute 25-Item Visual Function Questionnaire (NEI-VFQ 25)". The NEI-VFQ 25 was administered during dispensing visits and after three months and was converted to quality-adjusted life years (QALYs) using the previously published results. A cost-effectiveness analysis was performed by estimating the cost per QALYs gained.

Results: The total median (IQR) (USD) cost per patient to avail any specialty, corneal, and scleral contact lenses was ₹57,878(89,567) ($693), ₹21,907(20,420) ($262) and ₹1,10,316(69,514) ($1321) respectively. The total cost per patient was comparable to that of the low-income group ($750) based on the gross domestic product per capita of India and considerably less than that of the middle ($6,407) and high-income groups ($49,607). The discounted benefit-cost ratio was found to be 136:1. The cost per QALYs gained was found to be ₹1,35,899($1,628) and ₹1,56,440 ($1,874) for corneal and scleral lenses respectively.

Conclusion: Specialty contact lenses are cost-beneficial and effective for patients with irregular cornea and ocular surface diseases. Considering economic differences, implementing health coverage plans, policies, or allocative decisions can make these lenses more affordable for every socioeconomic status people in India and reduce out-of-pocket expenses.