The economic and social costs of visual impairment and blindness in India

Abstract

Purpose: To provide a current estimate of the economic and social costs (or welfare costs) of visual impairment and blindness in India. Methods: Using evidence from the recently conducted Blindness and Visual Impairment Survey across India, the Lancet Global Health Commission on Global Eye Health and other sources, we developed an economic model that estimates the costs of reduced employment, elevated mortality risk, education loss for children, productivity loss in employment, welfare loss for the unemployed, and caregiver costs associated with moderate and severe visual impairment (MSVI) and blindness. Probabilistic sensitivity analyses were also conducted by varying key parameters simultaneously. Results: The costs of MSVI and blindness in India in 2019 are estimated at INR 1,158 billion (range: INR 947–1,427 billion) or $54.4 billion at purchasing power parity exchange rates (range: $44.5–67.0 billion), accounting for all six cost streams. The largest cost was for the loss of employment, whereas the the second largest cost was for caregiver time. A more conservative estimate focusing only on employment loss and elevated mortality risk yielded a cost of INR 504 billion (range: INR 348–621 billion) or $23.7 billion (range: $16.3–29.2 billion). Conclusion: Poor eye health imposes a non-trivial recurring cost to the Indian economy equivalent to 0.47% to 0.70% of GDP in the primary scenario, a substantial constraint on the country’s growth aspirations. Furthermore, the absolute costs of poor eye health will increase over time as India ages and becomes wealthier unless further progress is made in reducing the prevalence of MSVI and blindness.

Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost-effectiveness at scale

“…While this is a non-trivial amount, it is at least an order of magnitude less than the estimated $7¢ 2À$16¢4 billion annual welfare and productivity losses associated with visual impairment in India. 44 Cost-effectiveness analyses indicate that both camps and vision centers are cost-effective at averting DALYs on average. Since all strategies operate for potentially different target groups, optimal resource allocation would likely involve some mix of these strategies with the exact proportions for a given location dependant on local factors, such as remoteness, population density and proximity to surgical capacity.…”

The case for investment in eye health: systematic review and economic modelling analysis

“…We based the economic model on two recently published studies from India: an economic modelling study of welfare losses associated with blindness and moderate and severe visual impairment; 32 and a micro-costing analysis of interventions delivered at scale by six eye health providers. 31 We chose this example because the costing data allowed for analysis of eye health interventions delivered at scale.…”

“…These steps reflect probabilistic sensitivity analyses conducted in the original studies upon which we derived the benefit-cost analysis. 31 , 32 The simulation allows us to report 95% CIs on benefit-cost ratios.…”

“…We estimated benefits for interventions targeting the general population (vision centres, eye camps and door-to-door screening) using a welfare model. 32 The welfare includes benefits of increased employment, lower mortality risk, productivity gains in employment, welfare gains for the non-employed and avoided caregiver costs. The benefits for school screening are construed more narrowly as learning gains, where a standard deviation increase in test scores is associated with a 20% increase in adult income.…”

Vision and hearing problems and psychosocial outcomes: longitudinal evidence from the German Ageing Survey

“…Of those, approximately two out of three are over the age of 50 [ 1 ]. This visual impairment is associated with a significant economic and social burden [ 2 , 3 ]. Additionally, hearing impairment is frequent among older adults [ 4 , 5 ] and is associated with adverse health consequences [ 6 ].…”