Scholarlink

Introduction <p>Frequent intravitreal injections of anti-vascular endothelial growth factors (VEGFs) for diabetic macular oedema (DMO) pose challenges for healthcare systems, patients, and society. This study assessed the efficacy, safety, resource utilization, and costs of anti-VEGFs from a Dutch societal perspective.</p> Methods <p>A systematic literature review and indirect treatment comparison (ITC) compared the efficacy and safety of aflibercept 8&#xa0;mg with aflibercept 2&#xa0;mg, ranibizumab, faricimab, and bevacizumab. A Markov model estimated lifetime costs for unilateral or bilateral DMO treatment over 5&#xa0;years from a Dutch societal perspective. Break-even prices determined the cost-neutral price for each anti-VEGF compared to the least expensive option.</p> Results <p>The ITC found no significant differences in efficacy or safety among anti-VEGFs, leading to a cost-minimisation analysis. Over 5&#xa0;years, the mean number of injections ranged from 15.0 (aflibercept 8&#xa0;mg, flexible Q16 regimen) to 24.9 (bevacizumab, pro re nata regimen). Bevacizumab had the lowest 5-year per-patient cost (€80,315). Aflibercept 8&#xa0;mg followed at €83,577, with a break-even price of €560 per injection (− 23% vs. current price). Aflibercept 2&#xa0;mg (fixed regimen), faricimab, and ranibizumab (treat-and-extend) required price reductions of 74%, 63%, and 71%, respectively, to match bevacizumab.</p> Conclusion <p>Despite similar efficacy and safety, differences in treatment burden were identified among the anti-VEGFs, with the more durable regimen of aflibercept 8&#xa0;mg potentially reducing overall injection frequency compared to current care. Nevertheless, on the basis of current list prices, bevacizumab is the least expensive anti-VEGF for treating DMO. Aflibercept 8&#xa0;mg, aflibercept 2&#xa0;mg, faricimab, and ranibizumab could achieve cost-equivalence to bevacizumab if their medication prices were reduced by at least 23%, 74%, 63%, and 71%. These results could support future decision-making of healthcare providers and payers, encompassing aspects of medical costs, healthcare capacity use, and burden on patients as well as the healthcare system as a whole.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Anti-VEGFs for Diabetic Macular Oedema: Analysis of Efficacy, Safety, and Cost of More Durable Therapies from a Dutch Societal Perspective

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月7日

查看全文
  • Sara W. Quist,
  • Jeroen H. J. Paulissen,
  • Izabella Lunk,
  • Joao Carrasco,
  • Marrit A. Woudstra,
  • Michal Pochopien,
  • Mateusz Nikodem,
  • Catriona Crossan,
  • Sankha Amarakoon,
  • Freekje van Asten,
  • Maarten J. Postma

摘要

Introduction

Frequent intravitreal injections of anti-vascular endothelial growth factors (VEGFs) for diabetic macular oedema (DMO) pose challenges for healthcare systems, patients, and society. This study assessed the efficacy, safety, resource utilization, and costs of anti-VEGFs from a Dutch societal perspective.

Methods

A systematic literature review and indirect treatment comparison (ITC) compared the efficacy and safety of aflibercept 8 mg with aflibercept 2 mg, ranibizumab, faricimab, and bevacizumab. A Markov model estimated lifetime costs for unilateral or bilateral DMO treatment over 5 years from a Dutch societal perspective. Break-even prices determined the cost-neutral price for each anti-VEGF compared to the least expensive option.

Results

The ITC found no significant differences in efficacy or safety among anti-VEGFs, leading to a cost-minimisation analysis. Over 5 years, the mean number of injections ranged from 15.0 (aflibercept 8 mg, flexible Q16 regimen) to 24.9 (bevacizumab, pro re nata regimen). Bevacizumab had the lowest 5-year per-patient cost (€80,315). Aflibercept 8 mg followed at €83,577, with a break-even price of €560 per injection (− 23% vs. current price). Aflibercept 2 mg (fixed regimen), faricimab, and ranibizumab (treat-and-extend) required price reductions of 74%, 63%, and 71%, respectively, to match bevacizumab.

Conclusion

Despite similar efficacy and safety, differences in treatment burden were identified among the anti-VEGFs, with the more durable regimen of aflibercept 8 mg potentially reducing overall injection frequency compared to current care. Nevertheless, on the basis of current list prices, bevacizumab is the least expensive anti-VEGF for treating DMO. Aflibercept 8 mg, aflibercept 2 mg, faricimab, and ranibizumab could achieve cost-equivalence to bevacizumab if their medication prices were reduced by at least 23%, 74%, 63%, and 71%. These results could support future decision-making of healthcare providers and payers, encompassing aspects of medical costs, healthcare capacity use, and burden on patients as well as the healthcare system as a whole.