Cost-utility of ranibizumab versus aflibercept for treating Greek patients with visual impairment due to diabetic macular edema. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Kourlaba, Georgia; Relakis, John; Mahon, Ronan; Kalogeropoulou, Maria; Pantelopoulou, Georgia; Kousidou, Olga; Maniadakis, Nikos
• Is Part Of: Cost effectiveness and resource allocation. Volume 14:Issue 1(2016)
• Page Start: 1
• Page End: 9
• Publication Date: 2016-12
• Subjects: Ranibizumab -- Aflibercept -- Diabetic macular edema -- Cost-effectiveness; Medical care -- Cost effectiveness -- Periodicals; Medical economics -- Periodicals; Resource allocation -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical ethics -- Periodicals; Medical care -- Political aspects -- Periodicals; 338.433621
• DOI: 10.1186/s12962-016-0056-1
• Languages: English
• ISSNs: 1478-7547

Abstract

Abstract Background To conduct a cost-utility analysis of ranibizumab versus aflibercept for the treatment of patients with visual impairment due to diabetic macular edema (DME) in the Greek setting. Methods A Markov model was adapted to compare the use of ranibizumab 0.5 mg (pro re nata-PRN and treat and extend-T&E) to aflibercept 2 mg (every 8 weeks after five initial doses) in DME. Patients transitioned at a 3-month cycle among nine specified health states (including death) over a lifetime horizon. Transition probabilities, utilities, as well as DME-related mortality were extracted from relevant clinical trials, a network meta-analysis and other published studies. The analysis was conducted from payer perspective and as such only costs reimbursed by the payer were considered (year 2014). The incremental cost per quality-adjusted life year (QALY) gained and the net monetary benefit was the main outcome measures. Results Τhe use of PRN and T&E ranibizumab regimens were shown to be cost saving comparing to aflibercept (by €2824 and €22, respectively), and more beneficial in terms of QALYs gained (+0.05) and time without visual impairment (0.031 and 0.034 years), thereby dominating aflibercept. Moreover, ranibizumab used as PRN or T&E resulted in a net monetary benefit of €3984 and €1278, respectively. Conclusions Both PRN and T&E ranibizumab regimens were more beneficial and less costly compared to aflibercept for the management of DME. Hence, ranibizumab seems to be a dominant option for the treatment of visual impairment due to DME in the Greek setting.