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Journal Title:

International Journal of Retina and Vitreous


Volume 3, Number 1


BioMed Central | 2017-12, Pages 5-5

Type of Work:

Article | Final Publisher PDF

Abstract: BackgroundTo 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.MethodsValue-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.ResultsUsing 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.ConclusionsRanibizumab 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.

Subjects: Health Sciences, Opthamology - Health Sciences, Rehabilitation and Therapy - Keywords: Ranibizumab - Cost-utility analysis - Age-related macular degeneration - Clinical cost-utility model -

Autor: Gary Brown, Melissa Brown, Heidi B. Lieske, Adam Turpcu, Yamina Rajput,



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