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The comparative effectiveness and cost-effectiveness of ranibizumab for neovascular macular degeneration revisited. | LitMetric

The comparative effectiveness and cost-effectiveness of ranibizumab for neovascular macular degeneration revisited.

Int J Retina Vitreous

The Healthcare Economics Unit, Genentech, Inc., South San Francisco, CA USA.

Published: February 2017

AI Article Synopsis

  • The study evaluates the long-term effectiveness and cost-effectiveness of ranibizumab therapy for neovascular age-related macular degeneration (AMD) by analyzing nearly a decade of data and various cost perspectives.
  • Using data from clinical trials, findings show that ranibizumab therapy improves patient quality of life (16.3% gain) and significantly reduces costs (33.8% decrease from 2006), demonstrating better economic viability.
  • The results indicate that ranibizumab therapy provides substantial financial returns to society, with a societal cost-utility ratio of -$242,920 per quality-adjusted life year (QALY), highlighting its value and effectiveness compared to past data.

Article Abstract

Background: To compare a near decade of follow-up, newer control cohort data, use of both the societal and third party insurer cost perspectives, and integration of unilateral/bilateral therapy on the comparative effectiveness and cost-effectiveness of intravitreal ranibizumab therapy for neovascular, age-related macular degeneration (AMD).

Methods: Value-Based Medicine, 12-year, combined-eye model, cost-utility analysis employing MARINA and HORIZON clinical trial data. Preference-based comparative effectiveness outcomes were quantified in (1) QALY (quality-adjusted life-year) gain, and (2) percent improvement in quality-of-life, while cost-effectiveness outcomes were quantified in (3) the cost-utility ratio (CUR) and financial return-on-investment (ROI) to society.

Results: Using MARINA and HORIZON trial data and a meta-analysis control cohort after 24 months, ranibizumab therapy conferred a combined-eye patient value (quality-of-life) gain of 16.3%, versus 10.4% found in 2006. The two-year direct ophthalmic medical cost for ranibizumab therapy was $46,450, a 33.8% real dollar decrease from 2006. The societal cost perspective CUR was -$242,920/QALY, indicating a $282,517 financial return-on-investment (ROI), or 12.3%/year to society for direct ophthalmic medical costs expended. The 3rd party insurer CUR ranged from $21,199/QALY utilizing all direct, medical costs, to $69,591/QALY using direct ophthalmic medical costs.

Conclusions: Ranibizumab therapy for neovascular AMD in 2015, considering treatment of both eyes, conferred greater patient value gain (comparative effectiveness) and improved cost-effectiveness than in 2006, as well as a large monetary return-on-investment to the Gross Domestic Product and nation's wealth. The model herein integrates important novel features for neovascular age-related macular degeneration, vitreoretinal cost effectiveness analyses, including: (1) treatment of both eyes, (2) a long-term, untreated control cohort, and (3) the use of societal costs.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304393PMC
http://dx.doi.org/10.1186/s40942-016-0058-3DOI Listing

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