VALUE OF THERAPEUTIC DURABILITY IN VISION HEALTH: SIMULATING CLINICAL CAPACITY WITH FARICIMAB FOR DME AND NAMD IN IMSS (INSTITUTO MEXICANO DEL SEGURO SOCIAL)
Author(s)
Adriana Ureña, BSc1, Emilio Muciño, MSc1, Karen Palacios, MSc1, Ernesto M. Nogueira, MBA2.
1Roche Mexico, Mexico City, Mexico, 2ValueConnected Consultoria, Sao Paulo, Brazil.
1Roche Mexico, Mexico City, Mexico, 2ValueConnected Consultoria, Sao Paulo, Brazil.
OBJECTIVES: To quantify the operational capacity and budget impact associated with increased faricimab adoption versus current aflibercept-dominant practice in the Instituto Mexicano del Seguro Social (IMSS) for diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD), beyond conventional assessments based solely on drug costs.
METHODS: A 5-year cost-consequence simulation compared two scenarios for 4,923 treatment-naive DME/nAMD patients: (A) status quo with aflibercept 2 mg 95.1%, faricimab 4.9% share; (B) progressive faricimab adoption +10% annual market-share. Model inputs: 61,250 annual vials; public prices (ex. rate MXN 20.48/€) €231/€415 (aflibercept 2 mg/faricimab); weighted bilaterality 1.45; DME/nAMD split 86.8%/13.2%; IMSS tariffs administration €205, consultation €102, Optical Coherence Tomography €70. Injection frequencies from trials (YOSEMITE/RHINE, TENAYA/LUCERNE, VIVID-VISTA, VIEW 1 and 2) 3-injection optimized faricimab loading dose, maintenance intervals were adjusted using strict anatomical control criteria (dry macula and Central Subfield Thickness). Outputs: cumulative injections avoided, liberated capacity (40 min/injection), additional faricimab patient-years and 5-year budget impact.
RESULTS: Faricimab reduced injection burden from 33.0 to 23.4 per patient over 5 years (29% reduction, ~6.5 clinical hours saved per patient). Population-wide, the pathway avoided 9,742 injections, liberating ~6,495 clinical hours. The scenario delivered ~11,156 additional faricimab patient-years (≈2,200 transitioned patients; 16,242 eye-treatments). Cumulative costs decreased by ~€1.6 million, as reduced administration and follow-up expenses from fewer injections outweighed faricimab's unit price.
CONCLUSIONS: Simulations indicate that progressive faricimab adoption at IMSS yields cost savings and increased clinical capacity within the existing medication budget. Incorporating real-world IMSS factors like transfers and logistics extends procedural time to 40 minutes per instance, further enhancing projected capacity gains. Standard economic evaluations frequently miss the significant value durable next-generation therapies offer systems with capacity constraints.
METHODS: A 5-year cost-consequence simulation compared two scenarios for 4,923 treatment-naive DME/nAMD patients: (A) status quo with aflibercept 2 mg 95.1%, faricimab 4.9% share; (B) progressive faricimab adoption +10% annual market-share. Model inputs: 61,250 annual vials; public prices (ex. rate MXN 20.48/€) €231/€415 (aflibercept 2 mg/faricimab); weighted bilaterality 1.45; DME/nAMD split 86.8%/13.2%; IMSS tariffs administration €205, consultation €102, Optical Coherence Tomography €70. Injection frequencies from trials (YOSEMITE/RHINE, TENAYA/LUCERNE, VIVID-VISTA, VIEW 1 and 2) 3-injection optimized faricimab loading dose, maintenance intervals were adjusted using strict anatomical control criteria (dry macula and Central Subfield Thickness). Outputs: cumulative injections avoided, liberated capacity (40 min/injection), additional faricimab patient-years and 5-year budget impact.
RESULTS: Faricimab reduced injection burden from 33.0 to 23.4 per patient over 5 years (29% reduction, ~6.5 clinical hours saved per patient). Population-wide, the pathway avoided 9,742 injections, liberating ~6,495 clinical hours. The scenario delivered ~11,156 additional faricimab patient-years (≈2,200 transitioned patients; 16,242 eye-treatments). Cumulative costs decreased by ~€1.6 million, as reduced administration and follow-up expenses from fewer injections outweighed faricimab's unit price.
CONCLUSIONS: Simulations indicate that progressive faricimab adoption at IMSS yields cost savings and increased clinical capacity within the existing medication budget. Incorporating real-world IMSS factors like transfers and logistics extends procedural time to 40 minutes per instance, further enhancing projected capacity gains. Standard economic evaluations frequently miss the significant value durable next-generation therapies offer systems with capacity constraints.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE578
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Methodological & Statistical Research
Topic Subcategory
Budget Impact Analysis
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Sensory System Disorders (Ear, Eye, Dental, Skin)