Continuous computer simulation analysis of the cost-effectiveness of screening and treating diabetic retinopathy

This paper analyzes the cost-effectiveness of screening and treating diabet ic retinopathy (DR) by simulating the disease progress continuously with ex isting data. A new computer simulation based on Monte Carlo techniques and logistic transformation follows cohorts from diabetes onset until death in five care scenarios. For younger-onset patients, ophthalmic care reduces th e prevalence of blindness by 52% or greater while savings in disability fac ilities and production losses surpass direct costs. For older-onset patient s, less favorable results appear. Financial benefits surpass costs for juve nile-onset patients. For other patients, the net costs of ophthalmic care s eem lower than in other health care programs.