Real-World Cost-Utility of Faricimab vs. Current and Future Anti-VEGF Therapies in Patients With Neovascular Age-Related Macular Degeneration in Italy
Author(s)
Camilla Porta, MSc1, Gianni Ghetti, MA1, ANTONIO FASCI, MSc2, Laura Bianchino, MSc2.
1AdRes HE&OR, Turin, Italy, 2Roche SpA, Monza, Italy.
1AdRes HE&OR, Turin, Italy, 2Roche SpA, Monza, Italy.
OBJECTIVES: The real-world evidence has corroborated findings from faricimab clinical trials (F-CTs): the VOYAGER (NCT05476926) study validated its effectiveness, while the FARIT study (SL45055) confirmed its durability. In Italy established anti-VEGF therapies have shown suboptimal adherence and persistence in clinical practice. This study aimed to evaluate the cost-utility of faricimab versus current and future anti-VEGF (standard of care, SoC) in a real-world setting from the perspective of Italian National Health Service (NHS).
METHODS: A 28-day cycle Markov model was used to estimate lifetime clinical and economic outcomes of nAMD patients treated with faricimab or SoC. SoC treatment effectiveness, injection frequency, and persistence were sourced from the RADIANCE study. For faricimab, two scenarios were investigated: (A) efficacy data from VOYAGER combined with F-CTs adherence and persistence, and (B) F-CTs efficacy paired with FARIT compliance data. Quality of life was based on published utilities, with decrements applied for intravitreal administration. Direct costs were obtained from Italian sources. List prices were applied for current drugs, and estimated for future biosimilars in line with current legislation. Societal perspective including indirect costs was evaluated. Costs and health gains were discounted at annual 3% rate. Sensitivity analyses assessed parameter uncertainty.
RESULTS: Faricimab generated an additional 1.11 and 1.35 QALYs compared to SoC in scenarios A and B, respectively, with incremental costs of approximately €33k and €35k per patient. The incremental cost-utility ratios ranged from €26k to €30k per QALY gained, with over 85% probability of cost-effectiveness at a willingness-to-pay threshold of €33k per QALY. When including indirect costs, the incremental cost decreased to roughly €19k in both scenarios.
CONCLUSIONS: Faricimab was cost-effective compared to current and future anti-VEGF biosimilars for nAMD treatment in the Italian real-world setting across both scenarios. Its value, driven by improved durability and persistence, is further strengthened when indirect costs are considered.
METHODS: A 28-day cycle Markov model was used to estimate lifetime clinical and economic outcomes of nAMD patients treated with faricimab or SoC. SoC treatment effectiveness, injection frequency, and persistence were sourced from the RADIANCE study. For faricimab, two scenarios were investigated: (A) efficacy data from VOYAGER combined with F-CTs adherence and persistence, and (B) F-CTs efficacy paired with FARIT compliance data. Quality of life was based on published utilities, with decrements applied for intravitreal administration. Direct costs were obtained from Italian sources. List prices were applied for current drugs, and estimated for future biosimilars in line with current legislation. Societal perspective including indirect costs was evaluated. Costs and health gains were discounted at annual 3% rate. Sensitivity analyses assessed parameter uncertainty.
RESULTS: Faricimab generated an additional 1.11 and 1.35 QALYs compared to SoC in scenarios A and B, respectively, with incremental costs of approximately €33k and €35k per patient. The incremental cost-utility ratios ranged from €26k to €30k per QALY gained, with over 85% probability of cost-effectiveness at a willingness-to-pay threshold of €33k per QALY. When including indirect costs, the incremental cost decreased to roughly €19k in both scenarios.
CONCLUSIONS: Faricimab was cost-effective compared to current and future anti-VEGF biosimilars for nAMD treatment in the Italian real-world setting across both scenarios. Its value, driven by improved durability and persistence, is further strengthened when indirect costs are considered.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE635
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Sensory System Disorders (Ear, Eye, Dental, Skin)