IVT-AFL 2q8 versus ranibizumab 0.5q4, and an indirect comparison of IVT-AFL 2q8 with ranibizumab 0.5PRN data. A de novo health economic model combined these clinical inputs with Dutch-specific costs associated with treatment, monitoring, and indirect caregiving, and utility inputs relevant to a Dutch population. Total quality-adjusted life-years (QALYs) and costs were calculated over a 15-year horizon. Uncertainty around the outcomes was tested through sensitivity analyses. Results: Compared with ranibizumab 0.5q4, a 2-year treatment IVT-AFL is associated with a significantly lower cost of € 7337 (95% CI: € 7248-€ 7435) over a 15-year horizon. There is no significant difference in QALYs (-0.0027 [95% CI: -0.0057 to 0.0001]). IVT-AFL 2q8 also has significantly lower total costs than ranibizumab 0.5PRN (€ 2450 [95% CI: € 2349-€ 2549]), with a nonsignificant gain of 0.0007 QALYS (95% CI: -0.0023 to 0.0036). Probabilistic analyses show that, due to its lower costs, IVT-AFL 2q8 treatment had an estimated > 99% probability of being cost-effective compared with both of the ranibizumab treatment strategies at a willingness-to-pay threshold of € 20,000 per QALY, the proposed informal Dutch threshold. The univariate analyses did not alter the conclusions. ConClusions: The analysis showed that IVT-AFL 2q8 treatment is associated with cost savings versus ranibizumab 0.5q4 or 0.5PRN. There is no significant difference in total QALYs between the treatments. Due to lower overall costs, IVT-AFL is a costeffective treatment option for wAMD patients in the Netherlands.
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