Presentation (CTI)

OBJECTIVES: Standard Budget Impact Models (BIMs) often rely on clinical trial assumptions and originator list prices, which may not reflect local realities. This study evaluated the budget and capacity impact of first-line faricimab versus aflibercept 2mg biosimilar (including a partial switch to faricimab for sub-optimally managed patients) in neovascular age-related macular degeneration (nAMD) by integrating Real-World Evidence (RWE) and current biosimilar pricing into a localizable BIM
METHODS: A dynamic cohort model projected demand over a 5-year horizon (2026/27-2030/31) for an incident cohort of 200 nAMD patients annually (10% annual growth). To reflect UK realities, national assumptions were replaced with local RWE from a large tertiary hospital regarding injection frequencies and treatment switching behaviors. Acquisition costs compared faricimab (£857.00) against the aflibercept 2mg biosimilar (NHS indicative list price: £295.65). The model calculated combined drug, optical coherence tomography (OCT), outpatient visit, and intravitreal injection (IVT) delivery costs.
RESULTS: Using real-world injection frequencies, the model demonstrated faricimab's extended durability drives substantial operational efficiencies. In Year 5 (2030/31), the faricimab 1L scenario required 4,361 total injections compared with 5,200 for the aflibercept biosimilar 1L including partial switch to faricimab, resulting in an annual reduction of 839 injections. Despite the aflibercept biosimilar's lower unit cost, reduced treatment frequency and associated hospital visit costs with faricimab yielded a projected annual budget saving of £253,700 in 2030/31 alone.
CONCLUSIONS: Integrating RWE provides a more accurate reflection of local service pressures. Extended durability of faricimab offsets acquisition costs through reduced administration burden, yielding significant capacity relief and savings over lower-cost biosimilars. Furthermore, utilising static list prices structurally underestimates the financial impact of operational activity; thus, the projected capacity relief and financial savings represent a highly conservative estimate.