OBJECTIVES:

Faricimab is a bispecific antibody targeting ANG-2 and VEGF for the treatment of DME and nAMD. In the pivotal clinical trials, patients treated with faricimab in a Treat & Extend (T&E) regime required less frequent treatments compared to Aflibercept given every eight weeks (Q8W) with non-inferior vision changes. Clinical practice in Canada is typically characterized by pro re nata regimens as well as T&E. This research aims to assess the budget impact of faricimab vs. anti-VEGF treatments applied in such regimens.

METHODS:

A budget impact model was developed in Microsoft®Excel® to estimate drug costs related to the treatment of DME and nAMD. The analysis was based on the patient population estimated using province-specific data, Canadian epidemiological data, projected market shares, and list prices. Incremental drug costs were compared for each forecast year and over the entire three-year forecast period (2023 to 2025). We included a pan-Canadian analysis as well as a scenario analysis for two provinces (British Columbia and Ontario) to illustrate the impact of a bevacizumab first vs. no mandated first line use policy.

RESULTS:

Across Canada and combining both indications, it was estimated that faricimab resulted in cost savings of $10,045,236 for Year 1, $43,743,804 for Year 2, $88,675,700 for Year 3, and $142,464,740 cumulatively. Scenario analyses results showed the base case results were robust. The cumulative three-year costs savings in Ontario were $79,855,003 and $6,344,228 in British Columbia respectively.

CONCLUSIONS:

Over the three-year time horizon, it was estimated that the introduction of faricimab would lead to substantial cost savings. Albeit the savings were less pronounced in provinces with intensive use of bevacizumab, faricimab still leads to significant cost savings replacing less durable treatments. Given the cost savings and clinical benefit of faricimab, the availability provides an additional option in addressing the current unmet needs in DME and nAMD.