ECONOMIC EVALUATION OF FENOFIBRATE FOR REDUCING THE PROGRESSION OF DIABETIC RETINOPATHY IN THAILAND
Author(s)
Kwandao Malasai, PhD1, Usa Chaikledkaew, PhD2, Tanawan Kongmalai, PhD3, Nida Wongchaisuwat, MD4, Jiraphun Jittikoon, PhD5, Wanvisa Udomsinprasert, PhD5, Kyoo Kim, PhD6.
1Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, Thailand, 2Global Health Technology Assessment (GHTA) Research Center, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand, 3Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 4Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 5Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand, 6Abbott Products Operations AG, Allschwil, Switzerland.
1Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, Thailand, 2Global Health Technology Assessment (GHTA) Research Center, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand, 3Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 4Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 5Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand, 6Abbott Products Operations AG, Allschwil, Switzerland.
OBJECTIVES: Diabetic retinopathy (DR) is a major microvascular complication of diabetes mellitus that drives progressive vision loss and irreversible blindness, resulting in profound quality-of-life impairments and economic burdens. Although current literature indicates that fenofibrate can reduce the progression of DR, and may be cost-effective in certain settings, country-specific economic evaluations in Thailand remain limited. Therefore, this study aimed to evaluate the cost-effectiveness of fenofibrate for slowing the progression of DR in Thailand.
METHODS: A Markov model with a one-year cycle length was constructed to assess the costs and health outcomes of fenofibrate compared with standard care from a societal perspective over a 10-year time horizon. Transition probabilities were derived from the LENS randomized clinical trial. Utility values obtained from published studies using the EuroQol 5-Dimension (EQ-5D) instrument in Thai patients with diabetes. All costs were calculated in 2025 Thai Baht (THB) with United States Dollar (USD) equivalents provided. Both costs and outcomes were discounted at an annual rate of 3%. The primary outcome was expressed as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were conducted to evaluate parameter uncertainty.
RESULTS: The fenofibrate strategy demonstrated an estimated total cost of 154,267 THB ($4,574 USD), exceeding the total cost of standard care at 137,257 THB ($4,069 USD). However, fenofibrate yielded an incremental gain of 0.20 quality-adjusted life-years (QALYs). The ICER for fenofibrate was calculated at 85,692 THB ($2,541 USD) per QALY gained compared to standard care. One-way sensitivity analysis identified the unit cost of fenofibrate nanoparticle 145 mg as the most influential parameter. The cost-effectiveness acceptability curve demonstrated a 95% probability of fenofibrate being cost-effective at the Thai societal willingness-to-pay (WTP) threshold of 160,000 THB ($4,744 USD) per QALY gained.
CONCLUSIONS: Fenofibrate is likely to be cost-effective for reducing the progression of DR at the Thai societal willingness-to-pay threshold.
METHODS: A Markov model with a one-year cycle length was constructed to assess the costs and health outcomes of fenofibrate compared with standard care from a societal perspective over a 10-year time horizon. Transition probabilities were derived from the LENS randomized clinical trial. Utility values obtained from published studies using the EuroQol 5-Dimension (EQ-5D) instrument in Thai patients with diabetes. All costs were calculated in 2025 Thai Baht (THB) with United States Dollar (USD) equivalents provided. Both costs and outcomes were discounted at an annual rate of 3%. The primary outcome was expressed as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were conducted to evaluate parameter uncertainty.
RESULTS: The fenofibrate strategy demonstrated an estimated total cost of 154,267 THB ($4,574 USD), exceeding the total cost of standard care at 137,257 THB ($4,069 USD). However, fenofibrate yielded an incremental gain of 0.20 quality-adjusted life-years (QALYs). The ICER for fenofibrate was calculated at 85,692 THB ($2,541 USD) per QALY gained compared to standard care. One-way sensitivity analysis identified the unit cost of fenofibrate nanoparticle 145 mg as the most influential parameter. The cost-effectiveness acceptability curve demonstrated a 95% probability of fenofibrate being cost-effective at the Thai societal willingness-to-pay (WTP) threshold of 160,000 THB ($4,744 USD) per QALY gained.
CONCLUSIONS: Fenofibrate is likely to be cost-effective for reducing the progression of DR at the Thai societal willingness-to-pay threshold.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE327
Topic
Economic Evaluation
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)