HEALTH AND ECONOMIC OUTCOMES RELATED TO DELAY BETWEEN MEDICAL INDICATION AND TREATMENT WITH RANIBIZUMAB IN AGE-RELATED MACULAR DEGENERATION IN GREECE
Author(s)
Kourlaba G1, Chatzikou M2, Pantelopoulou G2, Maniadakis N3
1Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece, 2Novartis (Hellas) S.A.C.I.,, Athens, Greece, 3Department of Health Services Organization, National School of Public Health, Athens, Greece
OBJECTIVES: To examine the impact of delay between indication to treat and injection of ranibizumab for the management of age-related macular degeneration (wAMD), in Greece. METHODS: A Markov model was developed to estimate, in a lifetime horizon, the clinical and cost outcomes related to treatment with ranibizumab 0.5mg on a pro re nata protocol: a) “without delay” and b) “with delay” between medical indication and treatment administration. At monthly cycles, patients’ visual acuity could increase by 3 lines, remain the same, or decrease by 3 lines. As for the “without delay” arm, the number of injections and transition probabilities were obtained from the CATT trial, while for the “with delay” arm, a one-month delay at first treatment was assumed, based on local experts estimation, and then the delay at re-treatment was indirectly modeled by applying number of injections and transition probabilities as obtained from clinical trials evaluating the efficacy of a quarterly protocol of injections (i.e. PIER trial). The model assumes that patients discontinue treatment after the second year of treatment. Costs related to drug acquisition, administration, monitoring costs and blindness were considered in the analysis (2015). This model predicted: blind-years, quality-adjusted life-years (QALYs), and the direct costs from a payer perspective. RESULTS: Treatment without delay was found to be more beneficial compared to “with delay” treatment in terms of QALYs (4,487 vs. 4,190) and blind-years (1,084 vs. 1,511). The total lifetime cost was calculated to be €235 higher in patients treated without any delay, resulting in an ICER of €790 per QALY gained (well-below the threshold of €17,000). The higher drug acquisition cost observed in “without delay” arm was partially offset by the increased non-medical direct cost related to the “with delay” arm. CONCLUSIONS: Ranibizumab treatment of wAMD without delay seems to be a strongly cost-effective strategy in Greece.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PSS46
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Sensory System Disorders