Funding community eye care in Aotearoa: a preliminary cost estimate based on the Australian approach

INTRODUCTION: In Australia, Medicare-funded optometric eye examinations are available to eligible residents, and state-funded subsidies support specific population groups to access spectacles. Meanwhile, public funding for optometry services in Aotearoa New Zealand (NZ) is limited, and many people cannot access the services they need. AIM: This study aimed to estimate the cost of funding eye examinations and spectacle subsidies in NZ based on the Australian model. METHODS: We identified publicly available data describing uptake of Medicare-funded optometry services (2022-2024) and the NSW Spectacles Program (2022-2023). We assumed that uptake would be similar across age groups, male/female gender, and ethnicity groups (First Nations Australians vs Māori or Pacific Peoples in NZ, and non-Indigenous Australians vs other New Zealanders) between the two countries, and applied Australia's uptake rates to NZ's 2024 population. The cost of itemised eye examinations was defined using the current Medicare rebates (eg A$66.15/~NZ$73.35 for comprehensive examinations) and Optometry Australia's recommended consultation fees (A$153.54/~NZ$170.24), and the median value of available state-level spectacle subsidy (A$200/~NZ$221.76). RESULTS: Extrapolating Australian uptake rates to our population in NZ would see ~2.4 million examinations delivered per annum at a cost of NZ$143m (using the Medicare rebate) and NZ$349m (using Optometry Australia's rate), as well as ~60,500 spectacles dispensed at a cost of NZ$13m. Targeting eye examinations and spectacles only to Community Services Card holders would cost NZ$50m to NZ$102m annually. DISCUSSION: Australia's eye care models may guide future policies in NZ with discussion needed on the most appropriate rebates to avoid exacerbating inequities.