Original Article

Economic Burden of Vision Loss and Eye Disorders in Iran

Abstract

Background: Globally, population growth and ageing are expected to increase the risk of vision impairment for more people. Eye disorders impose heavy social and economic burdens on communities through increased poverty, reduced quality of life, and decreased employment. Weaimed to calculate the economic burden of eye diseases in Iran.

Methods: Prevalence-based and top-down cost estimation methods were used with a sociological approach. Data were collected from the Northeastern Ophthalmology Center Institute for Health Assessment, and Evaluation, besides the 2017 census. Eye diseases were classified according to the ICD10. Data were analyzed using Excel 2016 software. 

Results: Survey data were collected from 19,113 patients with vision loss and eye disorders. The average cost of vision loss/eye disorders was estimated to be $250.3. The findings indicated that the economic burden of visual diseases was $2,844 million a year, with direct medical costs comprising 87% (66% of inpatient and 21% of outpatient) and direct non-medical and indirect costs estimated at 6% and 7%, respectively. Furthermore, 72.8% of direct medical costs was paid by insurance companies, 20.6% by patients, and 6.6% by the government. 

Conclusion: Eye diseases and vision loss in Iran, as in other countries, are costly for the health system and society. Instituting effective policies and measures to address this rising burden should be a national priority. Another suggestion in this area would be to focus on preventive care and policies such as health education, highlighting the role of reorientation of health services and advocacy (for policies that promote eye health), where relevant.

1. WHO (‎2010)‎. Action plan for the prevention of avoidable blindness and visual impairment, 2009-2013. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/103646
2. Wittenborn JS, Zhang X, Feagan CW, et al (2013). The economic burden of vision loss and eye disorders among the United States population younger than 40 years. Ophthalmology, 120(9):1728-35.
3. Pizzarello L, Abiose A, Ffytche T, et al (2004).VISION 2020: The Right to Sight: a global initiative to eliminate avoidable blindness. Arch Ophthalmol, 122(4):615-20.
4. Soori H, Ali JM, Nasrin R (2011). Prevalence and causes of low vision and blindness in Tehran Province, Iran. J Pak Med Assoc, 61(6):544-9.
5. Haileamlak A (2022). The Burden of Visual Impairment and Efforts to Curve it Down. Ethiop J Health Sci, 32(5):874.
6. Holden BA (2007). Blindness and poverty: a tragic combination. Clin Exp Optom, 90(6):401-3.
7. Pascolini D, Mariotti SP (2012). Global estimates of visual impairment: 2010. Br J Ophthalmol, 96(5):614-8.
8. Al-Namaeh M (2021). Common causes of visual impairment in the elderly. Med Hypothesis Discov Innov Ophthalmol, 10(4):191-200.
9. Mohammadi S-F, Saeedi-Anari G, Ashrafi E, et al (2017). Prevalence and major causes of visual impairment in Iranian adults: A systematic review. Middle East Afr J Ophthalmol, 24(3):148-155.
10. Rajavi Z, Katibeh M, Ziaei H, et al (2011). Rapid assessment of avoidable blindness in Iran. Ophthalmology, 118(9):1812-8.
11. Khairallah M, Kahloun R, Flaxman SR, et al (2014). Prevalence and causes of vision loss in North Africa and the Middle East: 1990–2010. Br J Ophthalmol, 98(5):605-11.
12. Askarzade E, Adel A, Ebrahimipour H, Badiee Aval S, Pourahmadi E, Javan Biparva A (2019). Epidemiology and Cost of Patients with Cancer in Iran: 2018. Middle East J Cancer, 10(4):362-71.
13. Jo C (2014). Cost-of-illness studies: concepts, scopes, and methods. Clin Mol Hepatol, 20(4):327-37.
14. Movahed MS, Barghazan SH, Adel A, Rezapour A (2021). Economic Burden of Stroke in Iran: A Population-Based Study. Value Health Reg Issues, 24:77-81.
15. Ebrahimipour H, Haghparast-Bidgoli H, Aval SB, et al (2022). Diagnostic and Therapeutic Costs of Patients With a Diagnosis of or Suspected Coronavirus Disease in Iran. Value Health Reg Issues, 27:21-4.
16. Yu J, Asche CV, Fairchild CJ (2011). The Economic Burden of Dry Eye Disease in the United States: A Decision Tree Analysis. Cornea, 30(4):379-87.
17. Fotouhi A, Hashemi H, Mohammad K, Jalali K (2004). The prevalence and causes of visual impairment in Tehran: the Tehran Eye Study. Br J Ophthalmol, 88(6):740-5.
18. Hatef E, Mohammadi S-F, Alinia C, et al (2016). National Burden of Eye Diseases in Iran, 1990–2010; findings from the global burden of diseases study 2010. Middle East Afr J Ophthalmol, 23(1):89-95.
19. Alipour V, Rezapour A, Adel A, et al (2023). Economical Evaluation of Cancer Types Using Intensity-Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy: A Systematic Review. Iran J Public Health, 52(7): 1355-66.‏
20. WHO (2009). WHO guide to identifying the economic consequences of disease and injury. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/137037.
21. IHME (2020). GBD Compare: Institute for Health Metrics and Evaluation. Available from: https://vizhub.healthdata.org/gbd-compare/
22. Hong N, Kim K, Lee I, et al (2012). The association between obesity and mortality in the elderly differs by serum concentrations of persistent organic pollutants: a possible explanation for the obesity paradox. Int J Obes, 36(9):1170-5.
23. Frick KD, Kymes SM, Lee PP, et al (2010). The cost of visual impairment: purposes, perspectives, and guidance. Invest Ophthalmol Vis Sci, 51(4):1801-5.
24. Akobundu E, Ju J, Blatt L, Mullins CD (2006). Cost-of-illness studies. Pharmacoecon, 24(9):869-90.
25. WHO (‎2004)‎. ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd ed. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/42980
26. Barber SL, Lorenzoni L, Ong P (‎2019)‎. Price setting and price regulation in health care: lessons for advancing universal health coverage. World Health Organization. Available from: https://apps.who.int/iris/handle/10665/325547.
27. Mehri N, Messkoub M, Kunkel S (2020). Trends, determinants and the implications of population aging in Iran. Ageing Int, 45(4):327-43.
28. Shaker AA, Akbari Sari A, Radin Manesh M, Fakhraei G, Fayazbakhsh A, Yousefi A (2018). Estimation of Economic Burden of Cataract Disease in Iran: A Cross-sectional Research. Jorjani Biomed J, 6(2):107-14.
29. Shakeri AA, Kazemi Karyani A, Akbari Sari A, Fakhraei G (2017). The Economic Burden of Glaucoma in Iran, 2012. Hakim Res J, 19(4).
30. Naidoo KS, Fricke TR, Frick KD, et al (2019). Potential lost productivity resulting from the global burden of myopia: systematic review, meta-analysis, and modeling. Ophthalmology, 126(3):338-46.
31. Rein DB, Zhang P, Wirth KE, et al (2006). The economic burden of major adult visual disorders in the United States. Arch Ophthalmol, 124(12):1754-60.
32. Taylor H, Pezzullo M, Keeffe J (2006). The economic impact and cost of visual impairment in Australia. Br J Ophthalmol, 90(3):272-5.
33. Wang B, Congdon N, Bourne R, et al (2018). Burden of vision loss associated with eye disease in China 1990–2020: findings from the Global Burden of Disease Study 2015. Br J Ophthalmol, 102(2):220-4.
34. Heidary R, Heidary F, Mahdavi MRV, Rahimi A, Gharebaghi R (2012). Potential negative impacts of social inequality on visual health: the possible pathophysiology mechanisms. Med Hypothesis Discov Innov Ophthalmol, 1(2):42.
35. Gharebaghi R, Heidary F, Heidary R, Mahdavi MRV (2010). Social determinants in ocular diseases. Clin Optom, 2:119.
Files
IssueVol 52 No 10 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v52i10.13859
Keywords
Economic burden Eye disorders Iran
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Rezapour A, Adel A, Aboutorabi A, Askarzade E, Barghazan S, Pourtaleb A, Tabatabaee SS. Economic Burden of Vision Loss and Eye Disorders in Iran. Iran J Public Health. 2023;52(10):2207-2215.