OBJECTIVES: Diabetic Macular Edema (DME) and neovascular Age-related Macular Degeneration (nAMD) cause vision loss leading to morbidity and loss of health-related quality of life. Treatment in those countries is based on laser and anti-vascular endothelial growth factor (VEGF). Our objective is to estimate the economic burden generated by these diseases in Honduras, El Salvador & Dominican Republic to have information that allows decision-makers to estimate the magnitude of this problem in the country.

METHODS: A Panel Delphi, bottom-up cost analysis was performed with ophthalmology and retinology experts from countries. Experts differentiated resources of the public and private healthcare systems and the costs of them. A list of the most used health resources (identified from the scientific literature) was evaluated with each expert in the care of these patients, calculating the probability and frequency of their use; finally, each expert identified the differences in healthcare processes, avoiding the halo effect. Finally, the costs (USD 2023) were obtained from tariff manuals and those reported by the experts.

RESULTS: The average-annual-cost of healthcare for a patient with DME in Honduras, El Salvador & Dominican Republic are $10,445; $14,741 & $11,164; respectively, 29-42% of which are indirect costs (carer and loss of productivity due to vision loss). Intravitreal injections for DME represent 30-54% of the total cost. The average-annual-cost of healthcare for a patient with nAMD in Honduras, El Salvador & Dominican Republic are $9,860, $12,550 & $10,509; respectively, 30-49% of which are indirect costs. Intravitreal injections with nAMD represent 33-54% of the total cost.

CONCLUSIONS: The annual cost of patients with DME and nAMD in Honduras, El Salvador & Dominican Republic fluctuates between $9,860 and $14,741, and almost half of them are due to intravitreal injection for treating these pathologies.