PSS19 Economic Evaluation of Ranibizumab for the Treatment of Macular Edema Secondary to Branch and Central Retinal Vein Occlusion in Canada

Haig, J.; Lawrence, Dale N.; Barbeau, M; Blouin, Julie; Zaour, N.

doi:10.1016/j.jval.2012.08.2066

Cited by 1 publication

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“…Cost and economic outcome data were available from seven studies, of which four [ 29 – 32 ] used cost-utility analysis and three [ 33 – 35 ] used cost-effectiveness analysis. Of the seven studies, six [ 29 – 32 , 34 , 35 ] were obtained from relevant conference proceedings and only one [ 33 ] was a full-text article, leading to lack of comprehensiveness in reported data. All studies were conducted in CRVO patients, without the ischemic status provided explicitly.…”

Section: Resultsmentioning

confidence: 99%

“…Key economic data reported across all studies were cost of treatment, administration costs, cost per QALY, and ICER, and key therapies studied were ranibizumab, dexamethasone intravitreal implants, and aflibercept. For two studies conducted in the UK, the analysis was carried out from a UK NHS perspective; [ 33 , 34 ] in contrast, studies from the USA ( n = 2) [ 31 , 35 ], Sweden ( n = 1) [ 29 ], and Canada ( n = 2) [ 30 , 32 ] used a payer/healthcare perspective, and another study from Canada used a societal perspective. All included studies calculated the costs of ME secondary to iCRVO but lacked economic data for NV complications.…”

Section: Resultsmentioning

confidence: 99%

“…One study expressed costs in 2011 GBP [ 33 ], another in 2012 Canadian dollars [ 30 ], and another in 2011 USD [ 31 ]. For the rest of the studies, which did not report the currency-year, the year of publication was assumed to be the currency-year [ 29 , 32 , 34 ]. Sensitivity analysis was reported in all [ 29 – 31 , 33 – 35 ] but one study [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the USA, the ICER for ranibizumab was £24,882 versus dexamethasone intravitreal implant from a payer perspective [ 31 ]. For a patient cohort aged 66–68 years, Haig et al [ 32 ] found that the ICERs for ranibizumab were £16,243 and £1218 (2015 values) if conducted through a Canadian payer perspective and a societal perspective, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Systematic literature review of treatments for management of complications of ischemic central retinal vein occlusion

Bradshaw

Gala

Nanavaty³

et al. 2016

BMC Ophthalmol

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BackgroundTo understand the clinical and economic outcomes of treatments for managing complications of ischemic central retinal vein occlusion (iCRVO).MethodsWe conducted a systematic literature review by searching multiple databases and ophthalmology conferences from 2004 to 2015. Studies published in English language and populations of age ≥45 years were included. For clinical endpoints, we defined eligibility criteria as randomized controlled trials, prospective before-and-after study designs, and non-randomized studies reporting on treatments in patients with iCRVO. For economic endpoints, all types of study design except cost-of-illness studies were included. We evaluated the definitions of ischemia, clinical and economic endpoints, and rate of development of complications. Risk of bias was assessed for clinical studies using the Cochrane risk-of-bias tool.ResultsA total of 20 studies (1338 patients) were included. Treatments included anti-vascular endothelial growth factors (anti-VEGFs), steroids, and procedures primarily targeting macular edema and neovascularization. Ischemia was not defined consistently in the included studies. The level of evidence was mostly low. Most treatments did not improve visual acuity significantly. Development of treatment complications ranged from 11 to 57 %. Incremental cost-effectiveness ratios reported for anti-VEGFs and steroids were below the accepted threshold of GB£30,000, but considering such treatments only ameliorate disease symptoms they seem relatively expensive.ConclusionsThere is a lack of evidence for any intervention being effective in iCRVO, especially in the prevention of neovascularisation. iCRVO poses a significant clinical and economic burden. There is a need to standardize the definition of ischemia, and for innovative treatments which can significantly improve visual outcomes and prevent neovascular complications.

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