COST-UTILITY OF RANIBIZUMAB VERSUS AFLIBERCEPT FOR TREATING VISUAL IMPAIRMENT DUE TO DIABETIC MACULAR EDEMA IN GREECE

Author(s)

Kourlaba G¹, Relakis J², Mahon R³, Kalogeropoulou M⁴, Pantelopoulou G⁴, Kousidou O⁴, Maniadakis N⁵
¹Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece, ²Department Of Health Services Organization, National School Of Public Health, Athens, Greece, Athens, Greece, ³Novartis Ireland Limited, Dublin, Ireland, ⁴Novartis Hellas, Metamorfosis, Greece, ⁵Department of Health Services Organization, National School of Public Health, Athens, Greece

OBJECTIVES: To conduct a cost-utility analysis of ranibizumab versus aflibercept for the treatment of patients with visual impairment due to diabetic macular edema (DME) in the Greek setting METHODS: A Markov model was adapted to compare the use of ranibizumab 0.5mg (pro re nata-PRN and treat & extend-T&E) to aflibercept 2mg (every 8 weeks after 5 initial doses) in DME. Patients transitioned at a 3-month cycle among nine specified health states (including death) over a lifetime horizon. Transition probabilities, utilities as well as DME-related mortality incorporated in the model were extracted from relative clinical trials, a network meta-analysis and other published studies. The drug acquisition and administration costs as well as the costs of blindness and laser surgery were also incorporated in the analysis. The analysis was conducted from payer perspective and as such only costs reimbursed by the payer were considered (year 2014). Treatment costs and health outcomes were discounted by 3.5% annually. The incremental cost per quality-adjusted life year (QALY) gained and the net monetary benefit was the main outcome measures. Sensitivity analysis was conducted to test robustness of the model. RESULTS: Τhe use of PRN and T&E ranibizumab regimens were shown to be cost saving comparing to aflibercept by €2,824 and €22, respectively, and more beneficial in terms of QALYs gained (+0.05) and time without visual impairment (0.031 and 0.034 years), thereby dominating aflibercept. Moreover, ranibizumab used as PRN or T&E resulted in a net monetary benefit of €3,984 and €1,278, respectively. Sensitivity analysis revealed that the net monetary benefit for each regimen remained positive for all tested scenarios. CONCLUSIONS: Both PRN and T&E ranibizumab regimens were more beneficial and less costly compared to aflibercept for the management of DME. Hence, ranibizumab seems to be a dominant option for the treatment of visual impairment due to DME in the Greek setting.

Conference/Value in Health Info

2015-11, ISPOR Europe 2015, Milan, Italy

Value in Health, Vol. 18, No. 7 (November 2015)

Code

PSS44

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Sensory System Disorders

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