A Markov model of Diabetic Retinopathy Progression for the Economic Evaluation of a novel DR prognostic device, CHERE Working Paper 2007/14

The initial diagnosis of Diabetic Retinopathy (DR) is often in the advance stages of the condition, as patients are only promoted for an examination when sight has been affected. An innovative prognostic technique has recently been made available which can non-invasively detect the damaging effects of high blood glucose before the development of clinical symptoms. This innovation offers the opportunity to patients to make the necessary behavioural and medicinal modification to prevent further progress of the disease. This paper reports the development of a Markov model which emulates the natural progression of Diabetic Retinopathy based on data from clinical trials. The purpose of such a model is to estimate the chronic cost and health outcomes of DR, and it may be modified to reflect the potential changes in current practice or condition changes, hence allowing for an economic evaluation of the DR prognostic test. The implications and limitations of the model were also discussed in the paper.