OBJECTIVES

To evaluate the cost-effectiveness of ranibizumab compared with verteporfin photodynamic therapy (vPDT) in patients with choroidal neovascularization secondary to pathological myopia (mCNV) from Chinese societal perspective.

METHODS

A Markov model was constructed to simulate the long-term outcomes and costs of Chinese mCNV patients. Model health states were defined by the best-corrected visual acuity (BCVA) intervals ranging from ≤ 25 letters to 86-100 letters, with an extra absorbing state 'death'. Lifetime horizon was used, with a 3-month cycle length. Transition probabilities were calculated from the RADIANCE clinical trial and VIP clinical trial. Health state utilities were estimated through literature, and costs were estimated from the survey of 6 hospitals in China and published literature. The primary outcomes of the model were costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Uncertainty was addressed via univariate and probabilistic sensitivity analyses.

RESULTS

The lifetime costs of treating mCNV with ranibizumab and vPDT were ¥73,312 and ¥59,347, respectively. Ranibizumab treatment produced higher cumulative QALYs (10.72) than vPDT(10.29). Adopting a willingness to pay of ¥180,000/ QALY (3 times per-capita GDP, 2017 China) as the threshold, ranibizumab was found to be cost-effective compared with vPDT, with the ICER of ¥32,477/QALY. In the probabilistic sensitivity analysis, ranibizumab had a 99.9% probability of being cost-effective compared with vPDT at a willingness-to-pay threshold of ¥180,000/ QALY.

CONCLUSIONS

From Chinese societal perspective, ranibizumab is the cost-effective therapy for the treatment of mCNV compared with vPDT.