Presentation (CTI)

OBJECTIVES: Neovascular age-related macular degeneration (nAMD) significantly burdens both patients and the Dutch healthcare system, primarily due to the need for frequent anti-VEGF injections. In the Netherlands, national guidelines recommend off-label bevacizumab as the initial anti-VEGF treatment, largely due to pharmacoeconomic reasons. Faricimab, a new bispecific antibody, offers the potential for extended dosing intervals, which could reduce treatment burden and costs. However, comprehensive and robust data from both clinical studies and real-world settings are lacking regarding dosing intervals and injection frequency for patients transitioning from prior anti-VEGF treatments to faricimab. Therefore, the aim was to systematically quantify the reduction in injection frequency achieved with faricimab compared to other anti-VEGF agents and assess the potential cost implications for the Netherlands.
METHODS: We conducted a systematic review, searching PubMed for randomized controlled trials and real-world studies comparing faricimab to other anti-VEGFs in nAMD patients. Primary outcomes were mean injection frequency and treatment intervals. Artificial intelligence (AI) was utilized to assist with data extraction and verification of the screening process. Data were narratively synthesized, and Dutch cost data were applied to estimate the economic impact.
RESULTS: From 226 screened articles, 26 included studies showed that nAMD patients treated with faricimab required significantly fewer injections compared to those treated with prior anti-VEGF therapies. Furthermore, the synthesized data revealed that a substantial majority of faricimab patients achieved extended treatment intervals. These outcomes were consistent across both treatment-naïve and previously treated patient populations.
CONCLUSIONS: A lower injection frequency with faricimab can significantly reduce the clinical, patient, and economic burden of nAMD care in the Netherlands. This could translate into considerable cost savings from fewer procedures and monitoring visits, helping to alleviate strain on ophthalmology services. Our findings provide quantified evidence to inform national treatment guidelines and optimize resource allocation for the growing nAMD population.