OBJECTIVES: To assess effectiveness, cost and cost-effectiveness of Lucentis versus current medical practices in age related macular degenerescence in France. METHODS: A simulation decision framework over 1-year time horizon compares a new specific agent “Lucentis” versus usual care using two effectiveness endpoints: “vision acuity improvement rate” (greater than 15 letters at the EDTRS scale) and “rate of legal blindness avoided”. The two decision trees include various sequences of current therapies and laser treatment, including or not Lucentis. Data sources come from clinical data, literature and expert opinions for variability and uncertainty assumptions. Probabilistic sensitivity analyses were conducted taking into account specific distribution laws for each cost and effectiveness parameters. French costing data include direct medical costs, adaptative costs and social allowance in case of blindness. RESULTS: Rate of visual acuity improvement : Lucentis as first line agent is significantly more effective (p<0.001), providing greater treatment success rate of visual acuity improvement than usual care (48.8% versus 33.9.1%). Direct medical costs is 9123 Euros over 1 year for Lucentis compared to 7604 Euros for usual care. Mean cost-effectiveness is 18721 Euros /success for Lucentis versus 22543 Euros/success for usual care (p<0.001). Rate of legal blindness avoided: Lucentis as first line agent is significantly more effective (p<0.001), providing greater treatment success rate of legal blindness avoided than usual care (99.6% versus 93.1%). Direct medical costs is 10493 Euros over 1 year for Lucentis compared to 8016 Euros for usual care. Mean cost-effectiveness is 10526 Euros /legal blindness avoided for Lucentis versus 8607 Euros/legal blindness avoided for usual care. CONCLUSION: Lucentis significantly improve the rate of visual acuity improvement and reduces the rate of legal blindness. Lucentis is significantly more cost-effective than usual care in term of visual acuity improvement.