OBJECTIVES: Anti-vascular endothelial growth factor (anti-VEGF) therapies are the benchmark for treating Neovascular Age-Related Macular Degeneration (nAMD) and Diabetic Macular Edema (DME). New therapies can differ in method of action, injection frequency and cost. This study investigates differences in direct and indirect costs associated with faricimab (anti-VEGF/Ang2) and aflibercept 8mg (anti-VEGF) treatment for nAMD and DME patient populations in the US.

METHODS: A cost analysis from patient and societal perspectives compared direct costs (drug, administration, and adverse event management) and indirect costs (travel cost and productivity loss) in patients with nAMD or DME treated with faricimab versus aflibercept 8mg over 3 years. Incidence and prevalence of nAMD and DME, and cost inputs, were sourced from literature and publicly available sources. Injection frequency was derived from phase III clinical trials. A 3-mile average distance and mileage cost of $0.655/mile were used to estimate travel costs (Meer et. al 2022). Total travel time, calculated from the distance traveled (Phibbs et al 2016), and average wage ($33.7/hour) were used to estimate productivity loss.

RESULTS: Faricimab per-patient direct drug costs were $14K lower than aflibercept 8mg after 3 years. For patients with DME (~511K) and nAMD (~1.6M) and a 3-mile travel distance, the total estimated direct cost of treatment with faricimab was $75B versus $94B for aflibercept 8mg over 3 years. Travel cost and productivity loss were estimated at $125M and $290M for faricimab versus $133M and $307M for aflibercept 8mg, leading to overall direct and indirect cost-savings of $19B and $25M, respectively. Indirect cost-savings increase to $37M for faricimab at a 5-mile average distance traveled.

CONCLUSIONS: Compared to aflibercept 8mg, faricimab generated patient- and societal-cost-savings with lower direct and indirect costs. Long-term cost savings can reduce the economic burden of nAMD and DME disease management for patients and society.