We face a global epidemic of diabetes where the number of patients with diabetes in the world is estimated to go from 171 million in 2000 to at least 366 million in 2030. While public health programs with diabetic eye screening are very effective and indeed highly cost-effective, they are expensive to operate, owing to the very large number of patients. The cost per screening visit in the ophthalmologist based Icelandic screening system is approximately 53 Euros, and the cost involved in photographic screening programs in Europe is 30-40 Euros.

Let us assume that each screening visit in developed countries costs 40 Euros and the visit and travel takes 2 working hours of the patients´ time. Annual screening for one million diabetic patients would cost 40 million Euros and 2 million working hours and this cost could be reduced by 58% with our algorithm. It is estimated that the prevalence of diabetes in USA was 18 million in 2000 and will reach 30 million in 2030 and it is reasonable to assume that Europe’s somewhat larger population is in the same ballpark and we will estimate the current number at 25 million diabetic patients in each region.

In this case either Europe or USA would each need about one billion Euros and 50 million working hours annually to conduct a fixed annual diabetic eye-screening program.

Individualized risk assessment and screening in Europe or USA could save 580 million Euros and 29 million working hours each year in each region. In both cases the benefit of reduced prevalence of blindness would far outweigh the cost of screening.