OBJECTIVES: The rationale for this study was to provide data for the German health care system in order to investigate the assumption that ranibizumab is a cost-effective option for the treatment of neovascular AMD. METHODS: We modeled cost-effectiveness for ranibizumab-treatment of the patient's “better” eye based on the development of visual acuity in our phase III studies (ANCHOR/MARINA) compared to a control group who received best supportive care (e.g. visual aids, regular check-ups). In the base-case, we computed 6 treatments per year for 2 years and used the same patient entry age (77 years) and distribution of visual acuity of the model population as in our phase III studies. Utility values came from a study by Brazier et al. Costs and benefits were discounted annually at 5%. Costs of drugs and treatment procedures were determined based on German pharmacy retail prices, the German code book for physicians' fees (EBM 2000plus) and German DRGs. We conducted a sensitivity analysis in order to test the stability of our model assumptions. Variations of the base-case scenario included e.g. patient age: 50-85 years, visual acuity at start of therapy: btw. > 4.0 and 0.05-0.1 or duration of therapy: 1-3 years. RESULTS: The base-case scenario yielded the following costs per QALY: 16.882 € for predominantly classic lesions, 24.766 € for minimally classic chorioidal neovascularization (CNV) and 26.170 € for occult CNV. When weighing the costs per QALY according to the distribution of these lesion types (18%-25%-57%), the mean costs per QALY for the therapy of wet AMD with ranibizumab amount to 24.147 €. The treatment was cost-effective even under adverse conditions, e.g. longer treatment duration, high visual acuity at start of treatment, high patient age, increased costs per injection. CONCLUSION: Therapy of neovascular AMD with ranibizumab is cost-effective for all angiographic subtypes assuming a realistic variation of model parameters.