EXTENDED LOADING DOSE OF ANTI-VEGF TREATMENT IN DIABETIC MACULAR EDEMA PATIENTS- A COST-CONSEQUENCE ANALYSIS
Author(s)
de Andrés-Nogales F1, Ruiz-Moreno JM2, Oyagüez I3, Casado MA1
1Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Spain, 2Hospital Universitario Puerta de Hierro Majadahonda; Universidad Castilla-La Mancha; Vissum Corporación; RETICS-OFTARED, Instituto de Salud Carlos III, Majadahonda, Spain, 3Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain
Presentation Documents
OBJECTIVES To assess the clinical and economic consequences of an extension of the loading dose of anti-VEGF treatments from 3 to 6 months in patients with persistent central involved diabetic macular edema (DME) and visual impairment in Spain. METHODS This analysis was performed from the National Health System perspective, considering pharmaceutical treatment costs. Ex-factory unit prices (€, 2019) were considered for aflibercept and ranibizumab (€742) and bevacizumab (€341.71). Rate of responder/non-responder DME patients at months 3 and 6 were obtained from Protocol T post-hoc analysis (Bressler NM et al, 2018). RESULTS Persistent DME was present in 50.8% and 31.6% of the 190 patients treated with aflibercept at months 3 and 6, respectively. Among the 176 ranibizumab patients, 53.2% at month 3 and 41.5% at month 6 had persistent DME. Finally, DME was persistent in 72.9% and 65.6% of the 180 patients treated with bevacizumab at month 3 and 6, respectively. Based on the response/non-response rates, extending the loading dose from 3 to 6 monthly injections to non-responder patients would mean a cost of €214,863 to obtain 37 additional responder patients treated with aflibercept, €208,489 for the 21 added ranibizumab responder patients and €134,483 for the increased 13 responder patients with bevacizumab. The total number of extended injections (months 3-6) used in patients with persistent DME at month 6 was 180, 219 and 354 for aflibercept, ranibizumab and bevacizumab, respectively. CONCLUSIONS The extension of the anti-VEGF loading dose from 3 to 6 injections would mean that it would be needed to invest €5,883 (8 injections), €10,091 (14 injections) and €10,199 (30 injections) per additional patient (non-responder at month 3 and responder at month 6) responding to aflibercept, ranibizumab and bevacizumab, respectively. For the total of patients treated, on average €7,927 (14 injections) would be necessary per additional responder patient.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PSS8
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Disease Management, Trial-Based Economic Evaluation
Disease
Drugs, Sensory System Disorders