April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Incremental Cost-Utility Ratio of Intravitreal Aflibercept Compared with Ranibizumab for the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion
Author Affiliations & Notes
  • Alan F Cruess
    Ophthalmology, Dalhousie University, Halifax, NS, Canada
  • Mark Jeddi
    Bayer, Toronto, ON, Canada
  • Ron Goeree
    Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
  • Gord Blackhouse
    Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
  • Marianne Eriksson
    Bayer AB, Solna, Sweden
  • Footnotes
    Commercial Relationships Alan Cruess, Alcon (R), Bayer (R), Novartis (R); Mark Jeddi, Bayer (E); Ron Goeree, None; Gord Blackhouse, None; Marianne Eriksson, Bayer (E)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6089. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Alan F Cruess, Mark Jeddi, Ron Goeree, Gord Blackhouse, Marianne Eriksson; Incremental Cost-Utility Ratio of Intravitreal Aflibercept Compared with Ranibizumab for the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6089. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: An economic evaluation was conducted to determine the incremental cost-utility ratio of intravitreal aflibercept compared with ranibizumab for the treatment of macular edema (ME) secondary to central retinal vein occlusion (CRVO) over a lifetime horizon from the perspective of a Canadian publicly funded healthcare system.

Methods: The Markov model consisted of six health states based on the Early Treatment of Diabetic Retinopathy Study chart: no vision impairment (≥80 letters); mild vision impairment (79-65 letters); moderate vision impairment (64-50 letters); severe vision impairment (49-35 letters); total blindness (best corrected visual acuity counting fingers or worse); and death. Transitions between health states were captured in a transition probability matrix reflecting the proportions of patients moving between each health state according to the COPERNICUS and CRUISE trial data. Three different time periods were modeled: monthly treatment (0-24 weeks), PRN treatment (24-52 weeks) and long-term disease progression (52 weeks onwards). Direct medical costs for the visual acuity health states were based on data from a 2008 multi-country survey of patients with visual impairment. Costs and outcomes occurring after 12 months were discounted at a rate of 5% per annum.

Results: Deterministic analyses show that treatment with intravitreal aflibercept provides 7.33 quality-adjusted life years (QALYs) at a cost of CDN$89,377 while treatment with ranibizumab resulted in 7.08 QALYs at a cost of CDN$95,006. The majority of 1,000 probabilistic modeling simulations indicate that treatment with intravitreal aflibercept is effective and less costly than ranibizumab. Cost-effectiveness acceptability curves demonstrated that the probability of intravitreal aflibercept being cost-effective at any willingness-to-pay threshold between CDN$0 and CDN$100,000 is greater than 90%. All sensitivity analyses reveal that intravitreal aflibercept dominated ranibizumab.

Conclusions: Intravitreal aflibercept is an effective and well tolerated option for the treatment of ME secondary to CRVO, and is cost-effective compared with ranibizumab.

Keywords: 749 vascular occlusion/vascular occlusive disease • 460 clinical (human) or epidemiologic studies: health care delivery/economics/manpower • 748 vascular endothelial growth factor  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×