The Real-World Cost-Effectiveness of Faricimab Versus Existing and Future Biosimilars in Patients with Neovascular Age-Related Macular Degeneration in Canada
Author(s)
Christian Bührer, PhD1, Oliver Cox, MRes2, Marloes Bagijn, PhD1, Demitri Diles, BA, MA3, Simon Yunger, BS3.
1F. Hoffmann-La Roche, Basel, Switzerland, 2RWE Lead, F. Hoffmann-La Roche, Basel, Switzerland, 3Hoffmann-La Roche Limited, Mississauga, ON, Canada.
1F. Hoffmann-La Roche, Basel, Switzerland, 2RWE Lead, F. Hoffmann-La Roche, Basel, Switzerland, 3Hoffmann-La Roche Limited, Mississauga, ON, Canada.
Presentation Documents
OBJECTIVES: Faricimab is a bispecific antibody targeting Angiopoietin-2 and VEGF-A for the treatment of neovascular age-related macular degeneration (nAMD). Non-inferior vision gains were observed in the TENAYA and LUCERNE trials when patients treated with up to Q16 week faricimab were compared with bimonthly aflibercept 2mg. Since its Canadian approval in May 2022, faricimab has been rapidly adopted into Canadian clinical practice and an extensive body of real-world evidence has been synthesised. This research aims to assess the cost-effectiveness of faricimab in a Canadian real-world setting versus existing and future biosimilars.
METHODS: A Markov cohort model was developed to estimate bilateral visual acuity changes linked to quality of life, injection frequency, and associated costs from a Canadian societal perspective. Visual acuity on treatment was informed by clinical trial data. Treatment persistence was based on real-world treatment patterns. Real-world injection frequencies were determined using Canadian-based electronic medical record data. Biosimilar costs were informed by a range of hypothetical discount rates. Furthermore, deterministic sensitivity analyses were conducted for costs and key model parameters.
RESULTS: In the base case, faricimab remained cost-effective through a range of biosimilar discount scenarios driven by its durability and persistence. At a range of large hypothetical originator to biosimilar discount rates, faricimab remained cost-effective versus both 2mg aflibercept and ranibizumab biosimilars.
In a scenario where informal care costs are excluded from the model, the conclusions were consistent as faricimab remained cost-effective versus aflibercept 2mg and ranibizumab biosimilars with substantial hypothetical discount rates.
CONCLUSIONS: The results demonstrate that faricimab is cost-effective versus both aflibercept 2mg and ranibizumab biosimilars reflecting likely local drug prices. Furthermore, the results indicate that drug acquisition costs are an increasingly small part of the overall cost of care. The results reinforce the need to consider costs beyond drug acquisition costs in payer decision-making.
METHODS: A Markov cohort model was developed to estimate bilateral visual acuity changes linked to quality of life, injection frequency, and associated costs from a Canadian societal perspective. Visual acuity on treatment was informed by clinical trial data. Treatment persistence was based on real-world treatment patterns. Real-world injection frequencies were determined using Canadian-based electronic medical record data. Biosimilar costs were informed by a range of hypothetical discount rates. Furthermore, deterministic sensitivity analyses were conducted for costs and key model parameters.
RESULTS: In the base case, faricimab remained cost-effective through a range of biosimilar discount scenarios driven by its durability and persistence. At a range of large hypothetical originator to biosimilar discount rates, faricimab remained cost-effective versus both 2mg aflibercept and ranibizumab biosimilars.
In a scenario where informal care costs are excluded from the model, the conclusions were consistent as faricimab remained cost-effective versus aflibercept 2mg and ranibizumab biosimilars with substantial hypothetical discount rates.
CONCLUSIONS: The results demonstrate that faricimab is cost-effective versus both aflibercept 2mg and ranibizumab biosimilars reflecting likely local drug prices. Furthermore, the results indicate that drug acquisition costs are an increasingly small part of the overall cost of care. The results reinforce the need to consider costs beyond drug acquisition costs in payer decision-making.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE230
Topic
Economic Evaluation
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin), STA: Biologics & Biosimilars