A pilot cost-benefit analysis of a children's spectacle reimbursement scheme: Evidence for Including children's spectacles in Mongolia's Social Health Insurance

Background and aimGlobally, 12.8 million children have vision impairment due to uncorrected refractive error (URE). In Mongolia, one in five children needs but do not have access to spectacles. This pilot cost-benefit analysis aims to estimate the net benefits of a children's spectacles reimbursement scheme in Mongolia. MethodsA willingness-to-pay (WTP) survey using the contingent valuation method was administered to rural and urban Mongolia respondents. The survey assessed WTP in additional annual taxes for any child with refractive error to be provided government-subsidised spectacles. Net benefits were then calculated based on mean WTP (i.e. benefit) and cost of spectacles. ResultsThe survey recruited 50 respondents (mean age 40.2 +/- 9.86 years; 78.0% women; 100% response rate) from rural and urban Mongolia. Mean WTP was US$24.00 +/- 5.15 (95% CI US$22.55 to 25.35). The average cost of a pair of spectacles in Mongolia is US$15.00. Subtracting the average cost of spectacles from mean WTP yielded a mean positive net benefit of US$9.00. ConclusionA spectacle reimbursement scheme is potentially a cost-effective intervention to address childhood vision impairment due to URE in Mongolia. These preliminary findings support the proposal of the inclusion of children's spectacles into existing Social Health Insurance. A much larger random sample could be employed in future research to increase the precision and generalisability of findings.

Automated summary

The aim of this pilot cost-benefit analysis is to estimate the net benefits of a children's spectacles reimbursement scheme in Mongolia. The survey results suggest that including spectacles in social health insurance may be a cost-effective intervention to address childhood vision impairment in Mongolia.