OBJECTIVES: The introduction of AI-enabled retinal screening has the potential to expand the ability to perform the diagnosis of Diabetic Retinopathy DR to optometrists, endocrinologists, pharmacists or even GPs. We seek to assess the overall budget impact of the introduction of automated AI-enabled DR screening in Germany.

METHODS: We conducted a budget impact analysis comparing the overall DR-related spending in Germany with and without the AI-enabled diagnostic solution. We include the projection of Diabetes Mellitus (DM) cases in Germany until 2045 and estimate that 21% will develop DR. Furthermore, we assume that approximately 11% of DM subjects are undiagnosed for DR. We consider different scenarios to expand the proportion of diagnosed subjects, the most optimistic case assuming that the full undiagnosed proportion can be captured. We consider additional scenarios on the proportion of subjects in the various DR stages, ranging from no DR to Progressive Diabetic Retinopathy (PDR). We include cost multipliers for subjects in different stages. PDR is over 7 times more expensive than no DR for healthcare systems. We assume that all the diagnosed subjects will go on to receive appropriate treatment, which will reduce the progression rate to more advanced stages of DR.

RESULTS: Under the assumptions considered, we estimate that the overall budget savings to the German Health System can be up to EUR 243 million over the next 5-years.

CONCLUSIONS: The impact of AI-enables solutions in diagnosis ophthalmic diseases, DR in particular, has the potential to bring a significant reduction in the overall health systems spending.