OBJECTIVES: Diabetic Macular Edema (DME) and neovascular Age-related Macular Degeneration (nAMD) cause vision loss leading to loss of health-related quality of life. Faricimab is a bispecific antibody that binds and inhibits both VEGF-A and angiopoietin-2. The aim is to estimate the budget impact (BI) of using Faricimab in Honduras (HON), El Salvador (SLV) & Dominican Republic (DR) public healthcare system.

METHODS: A BI model estimated the change in expenditure over a three-year time horizon for treating patients with DME or nAMD in the countries, assuming a cohort increasing by 3% of new patients annually with Faricimab. The comparators are Standard of Care (SoC), Aflibercept & Ranibizumab. Patients eligible to treat DME in SLV, DR & HON are respectively: 35,468; 80,847; 38,755 (48% have bilateral disease) and 4,016; 7,482; 3,378 for nAMD (36% have bilateral disease). Patients with DME treated with Faricimab receive 8.4 intravitreal injections in first-year and 4.9 after the second-year; 9.4 and 5.0 with Aflibercept; and 9.9 and 5.5 with SoC. Patients with nAMD treated with Faricimab receive 6.79 intravitreal injections annually and 4.69 after the second-year; 8.0 and 5.63 with Aflibercept; and 10.06 and 8.44 with SoC. Application costs were considered (visits & OCT scans). An advisory board performed in each country estimated direct and indirect healthcare costs.

RESULTS: First-year's BI in SLV, DR and HON are respectively: USD($)440,101; $1,809,024; $1,044,975; second year $887,785; $3,649,226; $2,107,959; third-year $1,342,700; $5,519,136; $3,188,105; and 3-year total BI is $2,670,586; $10,997,386; 6,341,039. The increase in using Faricimab per patient/year in SLV, DR and HON are respectively: $368,24; $677,12 and $819,37.

CONCLUSIONS: Faricimab has an economic impact of $2,7; $11 & $6 million dollars for the SLV, DR and HON healthcare system respectively in three years because the SoC is a very low-cost drug and Faricimab price considered was private, although it’s higher frequency of application.