Faricimab vs. Aflibercept 8 mg in Patients With Neovascular Age-Related Macular Degeneration: A Cost-Utility Analysis in Italy
Author(s)
Camilla Porta, MSc1, Gianni Ghetti, MA1, ANTONIO FASCI, MSc2.
1AdRes HE&OR, Turin, Italy, 2Roche SpA, Monza, Italy.
1AdRes HE&OR, Turin, Italy, 2Roche SpA, Monza, Italy.
OBJECTIVES: Faricimab in a treat&extend (T&E) regimen demonstrated non-inferiority to aflibercept 2mg at 1 year in the TENAYA/LUCERNE trials for neovascular age-related macular degeneration (nAMD). Recently, aflibercept (8mg) was investigated in the PULSAR and CANDELA trials, with PULSAR use more conservative criteria identifying disease activity. This study assessed the cost-utility of faricimab versus aflibercept 8mg in nAMD patients, from the perspective of Italian national health service (NHS) and society.
METHODS: A Markov model was adapted to the Italian setting to estimate lifetime clinical outcomes and costs of nAMD patients receiving faricimab or aflibercept 8mg. Transition probabilities were informed by faricimab trials, assuming equal efficacy between treatments. In the base-case analysis, injection frequencies for faricimab and aflibercept were derived from the TENAYA&LUCERNE trials and CANDELA trial, respectively. Alternative scenario analysis applied PULSAR data for aflibercept, with faricimab injection intervals adjusted to reflect PULSAR’s disease activity criteria. Health state utilities and the disutility related to intravitreal injections were obtained from published literature. Direct costs included drug acquisition and administration, while indirect costs included productivity loss. Unit costs were retrieved from Italian sources. Costs and health gains were discounted at 3% annually. Sensitivity analyses evaluated parameter uncertainty.
RESULTS: Faricimab yielded a slight QALY gain vs aflibercept 8mg due to the reduced frequency of intravitreal injections. From the NHS perspective, faricimab was cost-saving in both base-case (−€6,158) and alternative scenario analysis (−€3,033). When accounting for indirect costs, faricimab provided even greater savings. Sensitivity analyses confirmed the robustness of results.
CONCLUSIONS: This analysis indicates that faricimab T&E might be a cost-effective strategy in the treatment of nAMD in Italy when compared to aflibercept 8mg using treatment criteria aligned with clinical practice, from both NHS and societal perspectives. Those results also highlight the importance of treatment criteria and their harmonization conducting economic comparisons between anti-VEGF products.
METHODS: A Markov model was adapted to the Italian setting to estimate lifetime clinical outcomes and costs of nAMD patients receiving faricimab or aflibercept 8mg. Transition probabilities were informed by faricimab trials, assuming equal efficacy between treatments. In the base-case analysis, injection frequencies for faricimab and aflibercept were derived from the TENAYA&LUCERNE trials and CANDELA trial, respectively. Alternative scenario analysis applied PULSAR data for aflibercept, with faricimab injection intervals adjusted to reflect PULSAR’s disease activity criteria. Health state utilities and the disutility related to intravitreal injections were obtained from published literature. Direct costs included drug acquisition and administration, while indirect costs included productivity loss. Unit costs were retrieved from Italian sources. Costs and health gains were discounted at 3% annually. Sensitivity analyses evaluated parameter uncertainty.
RESULTS: Faricimab yielded a slight QALY gain vs aflibercept 8mg due to the reduced frequency of intravitreal injections. From the NHS perspective, faricimab was cost-saving in both base-case (−€6,158) and alternative scenario analysis (−€3,033). When accounting for indirect costs, faricimab provided even greater savings. Sensitivity analyses confirmed the robustness of results.
CONCLUSIONS: This analysis indicates that faricimab T&E might be a cost-effective strategy in the treatment of nAMD in Italy when compared to aflibercept 8mg using treatment criteria aligned with clinical practice, from both NHS and societal perspectives. Those results also highlight the importance of treatment criteria and their harmonization conducting economic comparisons between anti-VEGF products.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE461
Topic
Economic Evaluation
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)