Cost-effectiveness sequential modeling of ranibizumab versus usual care in age-related macular degeneration

Abstract

Ranibizumab significantly improved the rate of visual acuity improvement and reduced the rate of legal blindness. Ranibizumab appeared significantly more cost-effective than the usual treatments in terms of visual acuity improvement.

Anti-vascular endothelial growth factor for neovascular age-related macular degeneration

“…In independent studies and comprehensive reviews, visual acuity effects have been consistent with morphologic changes in the size and composition of the CNV lesion complex as well as with the observed change in CRT on OCT following treatment with these agents. In general, considerations of costs were limited in the trials included in this systematic review; additional analyses indicating a favorable cost utility ratio for anti-VEGF agents versus control or no treatment were cited in research using RCT and observational data (Cohen 2008; Earnshaw 2007; Fletcher 2008;Hernandez-Pastor 2008; Javitt 2008;Wolowacz 2007). Economic analyses have documented the lower cost of bevacizumab compared with ranibizumab to achieve the same benefits (Raftery 2007; Stein 2014).…”

Cost Effectiveness of Treatments for Wet Age-Related Macular Degeneration

“…For ranibizumab, four of the five studies identified (including HTA appraisals from the UK and Canada and cost-utility studies from the US and Germany) showed ranibizumab to be cost effective depending on time horizon; the cost-utility studies showed ICERs below commonly accepted thresholds (e.g. d30 000 or $US50 000 per QALY gained); [2,24,27,37] a fifth study in the US showed that ranibizumab was dominant over usual care when caregiver costs were taken into account, but not cost effective when caregiver costs were excluded. [26] Of five pegaptanib studies, one UK analysis found pegaptanib to be clearly cost effective versus best supportive care over a 10-year time horizon; [23] the other four studies (including a UK HTA) showed that the cost effectiveness of pegaptanib varied considerably depending on the stage of disease and time horizon.…”

“…Ranibizumab also reduced the rate of legal blindness, although costs per success for this endpoint were higher than with usual care. [37] By contrast, Hurley et al [26] found ranibizumab to be cost saving compared with usual care over a 10-year time horizon, when evaluated by cases of blindness prevented and blind-years prevented, and viewed from a societal perspective in the US. HTAs in the UK and Canada found 2 years of monthly ranibizumab injections to be associated with incremental costs per vision-year saved of d12 275 and $Can9542, respectively, for minimally classic or occult with no classic CNV, over a 10-year timeframe; incremental costs for predominantly classic CNV were d4929 and $Can5238, based on 1 and 2 years of ranibizumab treatment, respectively.…”

Cost and Effectiveness of Therapy for Wet Age-Related Macular Degeneration in Routine Clinical Practice

“…The main limitation of the submitted paper is its short period of time not allowing results presented in the form of the cost per vision year gained or quality-adjusted life year as known from the foreign models [16,17,18,19,20,22,24]. We have therefore restricted the comparative analyses of the cost-effectiveness to the cost of prevention of 1-line loss on the ETDRS chart.…”