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 on Guatemala's 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 Guatemala, assuming the cohort increases by 3% of new patients annually with Faricimab. The comparators are standard of care (SoC) (90% first-year), ranibizumab (7% first-year), and aflibercept (3% first-year). Patients eligible to treat DME are 32,090 (48% bilateral disease) and 2,383 for nAMD (36% bilateral disease). Patients with DME treated with Faricimab receive 8.4 intravitreal injections annually and 4.9 after the second year, 9.4 and 5.0 with Aflibercept, 9.5 and 5.4 with Ranibizumab, 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; 9.13 and 7.17 with ranibizumab; and 10.06 and 8.44 with SoC. Medical fees are $131 for every intravitreal injection, outpatient visits cost $72, and OCT scans and angiographies cost $70 for everyone. A Guatemalan advisory board estimated direct and indirect healthcare costs.

RESULTS: First-year's BI is $1,715,779; second-year is $3,461,130; third-year BI is $5,234,656; and 3-year total BI is $10,411,564. Patients with DME treated with Faricimab first year are 971, 1,959 second-year, and 2,963 third year. In addition, 72 patients with nAMD received Faricimab first-year, 146 second-year, and 220 third year.

CONCLUSIONS:

Faricimab has an economic impact of 10 million dollars for the Guatemalan healthcare system in three years because the SoC is a very low-cost drug, although it’s higher frequency of application.