OBJECTIVES: sVMA is a serious, sight-threatening and progressive condition which, if untreated, leads to irreversible retinal damage, vision loss, and reduced visual function. Current standard of care for sVMA is vitrectomy, which has a high rate of complications and requires patients to maintain a “head-down” position for up to two weeks, resulting in additional surgical costs, discomfort and significant caregiver burden. Ocriplasmin (Jetrea®), a single intravitreal injection to resolve sVMA, was recently approved in the UK and US. A budget impact analysis was performed to test the hypothesis that ocriplasmin can provide cost savings to a hypothetical managed care plan by reducing total vitrectomies to resolve sVMA. METHODS: An Excel-based economic model was designed from the perspective of a managed care plan to quantify total direct costs of treating patients with sVMA across two scenarios: 1) the current treatment paradigm, consisting of clinical management or vitrectomy, and 2) future treatment paradigm, which also includes ocriplasmin or ocriplasmin followed by vitrectomy. The model assumes costs are all-inclusive over a 1-year period and accounts for diagnosis and monitoring, vitrectomy, intravitreal injection procedures, pharmacy, and treatment of complications.  Costs were obtained from 2012 Medicare fee-for-service rates and Medicare claims using the 2005-2009 Outpatient and Part B 5% Standard Analytical Files. RESULTS: Based on an aggregate market penetration of 23% (replacing 44% of vitrectomy patients and 2.5% of clinical management patients), ocriplasmin reduces total vitrectomies by 35%, resulting in cost savings of $27,884 per year to a 1 million-member health plan. Major cost impact drivers include cost of vitrectomy and associated complications, cost of ocriplasmin and complications, and percent of ocriplasmin patients requiring vitrectomy.   CONCLUSIONS: In addition to reducing surgical complications and improving patient quality of life, ocriplasmin has the potential to reduce direct medical costs to a managed care plan for treating sVMA.