OBJECTIVE: To assess the cost-effectiveness of photodynamic therapy (PDT) with verteporfin as treatment for subfoveal choroidal neovascularisation (CNV) with small lesions (°Ü 4 macular photocoagulation study disc areas), relative to no treatment. METHODS: This analysis assesses the cost-effectiveness of PDT using verteporfin in patients with small subfoveal CNV lesions, based on results of two multicentre, double-blind, randomised, placebo-controlled trials (VIP and TAP). Data on visual acuity were collected for 24¨C48 months. Patients with visual acuity scores above the level of legal blindness in Australia (which is °Ü 34 letters) were defined as not blind. The proportion of patients not blind at each three-month interval was plotted on a °(r)vision curve°¯, which was extrapolated to 84 months. The area under this curve was calculated for each group. The difference in the area under the curve between groups represents the vision-years gained from treatment. A costing analysis was performed, based on an average of 3.4 treatments in the first year, 2.2 in the second year, 1.3 in the third year and 0.4 in the fourth year. Costs of nursing home, home and community care, falls and the disability pension considered to be due to visual decline were also included. RESULTS: Treatment using PDT with verteporfin results in a cost saving, relative to no treatment, of between $2909 and $4992 over the 7-year period, depending on assumptions made in the extrapolation of trial data. Over this period, between 1.801 and 2.194 vision-years were gained. Therefore, PDT with verteporfin is both less expensive and more effective than no treatment in this population. Sensitivity analyses demonstrated these results were robust to changes in the value of key variables. CONCLUSIONS: PDT with verteporfin represents a cost-effective intervention in the proposed population. There is currently no alternative therapy for patients with small subfoveal CNV lesions.