Cost-Utility and Budget Impact Analysis of Faricimab for Diabetic Macular Edema (DME) and Neovascular Age-Related Macular Degeneration (nAMD) in Indonesia
Author(s)
Neily Zakiyah, PhD1, Rano Kurnia Sinuraya, PhD1, Gassani Amalia, M.Sc2, Poppy Widiyani, Bpharm2, Sofa Dewi Alfian, PhD1, Rova Virgana, Dr3, Maula Rifada, Dr3, Irawati Irfani, Dr3, Rizky Abdulah, PhD1, Christian Bührer, PhD4, Oliver Cox, PhD4.
1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia, 2PT. Roche Indonesia, Jakarta, Indonesia, 3Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia, 4F. Hofmann-La Roche Ltd, Basel, Switzerland.
1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia, 2PT. Roche Indonesia, Jakarta, Indonesia, 3Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia, 4F. Hofmann-La Roche Ltd, Basel, Switzerland.
OBJECTIVES: Diabetic Macular Edema (DME) and Neovascular Age-Related Macular Degeneration (nAMD) are progressive retinal diseases with rising prevalence in Indonesia, causing substantial clinical and economic challenges. Faricimab, a bispecific antibody targeting VEGF-A and Angiopoietin-2, has the potential to enhance treatment outcomes with reduced injection frequency. This research aims to assess the cost-utility and budget impact of faricimab compared to ranibizumab, a standard anti-VEGF therapy in Indonesia.
METHODS: A cost-utility analysis was conducted using a Markov model over a 25-year horizon from payer and societal perspectives. Input parameters were derived from global literature and local data sources, including national surveys, health insurance claims, and expert opinions. Health outcomes were measured in quality-adjusted life years (QALYs), based on best-corrected visual acuity. Cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), using a willingness-to-pay threshold of up to three times Indonesia’s GDP per capita. Deterministic and probabilistic sensitivity analyses assessed uncertainty. A 5-year budget impact analysis assessed the financial implications of nationwide faricimab adoption in Indonesia.
RESULTS: For DME, faricimab using a T&E regimen with a price adjustment scenario dominated ranibizumab PRN, resulting in cost savings of IDR 5,274,216 (USD 320) and a QALY gain of 0.22. For nAMD, faricimab T&E also dominated ranibizumab T&E, generating cost savings of IDR 128,629,558 (USD 7,795) and a QALY gain of 0.02 from a societal perspective. Payer perspective results confirmed similar cost-saving trends. Sensitivity analyses identified drug prices, patient age, and intravitreal injection costs as key cost-effectiveness drivers. The five-year budget impact analysis projected substantial cost savings with faricimab adoption, reaching IDR 1.65 trillion (USD 100 million) for DME and IDR 154.32 billion (USD 9.35 million) for nAMD.
CONCLUSIONS: Faricimab presents a cost-effective alternative for DME and nAMD within Indonesia’s public health system. Its integration into national health insurance could improve patient access, adherence, and long-term outcomes.
METHODS: A cost-utility analysis was conducted using a Markov model over a 25-year horizon from payer and societal perspectives. Input parameters were derived from global literature and local data sources, including national surveys, health insurance claims, and expert opinions. Health outcomes were measured in quality-adjusted life years (QALYs), based on best-corrected visual acuity. Cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), using a willingness-to-pay threshold of up to three times Indonesia’s GDP per capita. Deterministic and probabilistic sensitivity analyses assessed uncertainty. A 5-year budget impact analysis assessed the financial implications of nationwide faricimab adoption in Indonesia.
RESULTS: For DME, faricimab using a T&E regimen with a price adjustment scenario dominated ranibizumab PRN, resulting in cost savings of IDR 5,274,216 (USD 320) and a QALY gain of 0.22. For nAMD, faricimab T&E also dominated ranibizumab T&E, generating cost savings of IDR 128,629,558 (USD 7,795) and a QALY gain of 0.02 from a societal perspective. Payer perspective results confirmed similar cost-saving trends. Sensitivity analyses identified drug prices, patient age, and intravitreal injection costs as key cost-effectiveness drivers. The five-year budget impact analysis projected substantial cost savings with faricimab adoption, reaching IDR 1.65 trillion (USD 100 million) for DME and IDR 154.32 billion (USD 9.35 million) for nAMD.
CONCLUSIONS: Faricimab presents a cost-effective alternative for DME and nAMD within Indonesia’s public health system. Its integration into national health insurance could improve patient access, adherence, and long-term outcomes.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD208
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)