The societal economic impact of vision impairment in adults 40 years and above: findings from the National Eye Survey of Trinidad and Tobago

BACKGROUND: Understanding and mitigating the societal economic impact of vision impairment (VI) is important for achieving the Sustainable Development Goals. AIM: To estimate the prevalent societal economic impact of presenting VI in Trinidad and Tobago using bottom-up cost and utilisation data from the 2014 National Eye Survey of Trinidad and Tobago. METHODS: A societal perspective combined comprehensive, individual-level cost and utilisation data with population-based prevalence estimates for VI and a contemporaneous national eyecare system survey. Direct (medical and non-medical) and indirect (productivity loss) costs, and intangible losses were included in total cost estimates, presented in 2014 Trinidad & Tobago (TT) dollars and UK sterling. Transfer payments and dead-weight losses were considered but excluded. Sensitivity analyses explored parameter uncertainty and assumptions. RESULTS: Utilisation and cost data were available for 65.5% (n=2792/4263) and 59.0% (n=2516/4263) of eligible participants aged ≥40 years, respectively (mean age 58.4 years; 56.3% female). Total societal cost of VI in 2014 was UK£365,650,241 (TT$3,842,324,655), equivalent to £675 per capita (population ≥40 years). Loss of wellbeing accounted for 73.3% of total. Excluding wellbeing loss, economic cost was UK£97,547,222 (TT$1,025,045,399): indirect costs 70.5%, direct medical 17.9%, direct non-medical 11.6%. CONCLUSION: This study provides a comprehensive estimate of the economic impact of vision loss in a Caribbean country and highlights the extent to which affected individuals and families bear the societal economic cost of VI.

T. Braithwaite, H. Bailey, D. Bartholomew, V. Maharaj, A. Fraser, F. Deomansingh, S. S. Ramsewak, V. Tripathi, S. Sharma, D. Singh, R. R. A. Bourne, A. Gray