- Ranibizumab (Lucentis) 0.3 mg is more cost-effective than aflibercept (Eylea) 2.0 mg for treating diabetic macular edema (DME), an advanced, vision-threatening complication of diabetic retinopathy.
Why this matters
- Treatment cost-effectiveness and effect on health-related QoL are important considerations when choosing an appropriate treatment for DME.
- Researchers modeled medication costs, visual acuity (VA)-related medical costs, and quality-adjusted life-years (QALYs) based on Medicare reimbursement rates in 2016 U.S. dollars and published literature.
- They stratified patients by baseline VA≥20/40 and ≤VA 20/50.
- Funding: Genentech.
- Total 2-year costs were higher with similar quality-adjusted life-years (QALYs) for aflibercept vs ranibizumab in all groups:
- All patients: $44,423 vs $34,529; 1.476 vs 1.466.
- VA ≥ 20/40: $40,854 vs $31,897; 1.517 vs 1.519.
- VA ≤ 20/50: $48,214 vs $37,246; 1.433 vs 1.412.
- Incremental cost-effectiveness ratios were also higher for aflibercept in the full cohort ($986,159/QALY) and VA ≤20/50 ($523,377/QALY).
- These ratios decreased to $711,301/QALY and $246,978/QALY, respectively, when researchers projected analyses to 10 years.
- VA was the only QALY parameter researchers analyzed.
- Analyses specifically excluded bevacizumab (Avastin), which is commonly used off-label to treat DME.