OBJECTIVES : Visual impairments (VI) have a huge impact on the quality of life. This study provides a comparison of benefit assessments for reimbursement in EU member states for medications in the five indications for visual impairment due to choroidal neovascularisation (CNV), to choroidal neovascularisation (CNV) secondary to pathologic myopia, to diabetic macular oedema (DMO), to macular oedema secondary to retinal vein occlusion (branch BRVO or central CRVO) and age-related macular degeneration (AMD).

METHODS : The international HTA database Prismaccess® includes benefits assessments, including the UK (NICE England, SMC Scotland, AWMSG Wales) HAS France, G-BA Germany, TLV Sweden, ZIN Netherlands, NCPE Ireland and regional and national decisions from Italy and Spain. All decisions on therapies for VI launched in these countries for the last 10 years were considered for a systematic reimbursement analysis, excluding reassessments of older drugs and biosimilar.

RESULTS : 72 decisions have been considered: HAS is leading, with 25 decisions, followed by SMC with 16, NICE with 13 and G-BA with five identified decisions. Fewer decisions could be associated for Wales (1) and Ireland (2). On national (N) and regional (R) level could be identified for Italy N1+R6 and Spain N3+R1. The level of added benefit differs in extent and between countries, e.g. SMC recommended 7 therapies, restricted 5 and did not recommend 4. NICE assessed 2 as accepted, 9 with restrictions and did not recommend 2. In France, 18 subgroups obtained a substantial SMR and 7 were rated as insufficient. Reasons are different appropriate comparator therapies, patient populations or economic data.

CONCLUSIONS : The analysis showed differences in the assessment of VI drugs between different market access authorities in Europe. Reasons vary and need to be taken into account in future market access submissions. In addition, patients might suffer from different country-specific access to new treatments.