Economic evaluation of the treatment of wet Age-Related Macular Degeneration with anti-VEGF therapies, aflibercepte or ranibizumab, from the private payer perspective.

Abstract

Introduction: The age-related macular degeneration is the leading cause of irreversible vision loss for people from 65 years of age and can occur in two forms: “dry” and “wet”. The anti-VEGF therapy is the first treatment of wet age-related macular degeneration to provide patients with the potential for improving visual acuity. Methods: We developed a cost-minimization model in the form of a Markov chain with six health states, one being the absorption state “death.” Each of these states represents a possible visual acuity level. The model takes into account the drugs, monitoring, and administration costs. The time horizon was 5 years with a discount rate of 5 %. The analysis was conducted from the private payer perspective. Results: The economic analysis suggests that treatment with aflibercept generates savings of R$ 17,101 per patient when compared to treatment with ranibizumab. Sensitivity analyzes were conducted and supports the robustness of the results. Conclusion: The cost minimization analysis revealed lower cost of treatment of wet age-related macular degeneration with aflibercept when compared to the treatment with ranibizumab.