PSS5 COMPARING TWO TREAT-AND-EXTEND ANTI-VEGF REGIMENS FOR MANAGING WET AGE-RELATED MACULAR DEGENERATION - IMPLICATIONS FOR THE NATIONAL HEALTH SYSTEM IN FRANCE

Abstract

To estimate and compare the cost of treatment of wet age-related macular degeneration (wAMD) with the use of intravitreal aflibercept (IVT-AFL) vs. ranibizumab (RBZ) treat-and-extend regimens (T&E) in France. Based on the findings from a network meta-analysis (NMA) that suggests comparable improvements in visual acuity after 2 years of treatment between both IVT-AFL/T&E and RBZ/T&E, and other existing evidence demonstrating a similar safety profile for both interventions, a cost-minimization model (CMM) was developed to compare economic outcomes for IVT-AFL/T&E and RBZ/T&E in patients with wAMD. Treatments were differentiated in the CMM based on the results of the NMA which showed a significantly lower number of injections for IVT-AFL/T&E after 2 years. A two-year time horizon was applied in order to directly use the available clinical data. The following cost categories were included in the model: drugs acquisition, administration and monitoring. Calculations were performed from the national health system perspective (NHS) in France. According to the base analysis, an average of 10.53 injections of IVT-AFL/T&E were administered per patient over a 2-year time horizon in comparison with 16.46 injections of RBZ/T&E. This difference of 5.93 in mean number of injections translated into an additional cost of €4,765 for RBZ/T&E over IVT-AFL/T&E. The total cost of 2-years of treatment was estimated to be €9,844 and €14,609 for IVT-AFL/T&E and RBZ/T&E respectively. Accordingly, 148 patients could be treated with IVT-AFL/T&E for 2 years at the same cost as 100 patients using RBZ/T&E. The use of IVT-AFL/T&E instead of RBZ/T&E leads to cost savings from NHS perspective in France while maintaining comparable effectiveness and safety outcomes for patients with wAMD.