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Rita Gonçalves, Pedro Coelho, Carla Teixeira, Rui Carvalho, Bruna Vieira, Tiago Maio; Real-life visual and anatomical outcomes with fluocinolone acetonide (FAc) and cumulative cost of treatment in the treatment of chronic diabetic macular edema (DME). Invest. Ophthalmol. Vis. Sci. 2017;58(8):72.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this retrospective analysis is to assess the visual and anatomical outcomes of the FAc implant and its budgetary impact over a 3-year period.
Data was collected from 21 patients (28 eyes) with DME and who had received a single intravitreal injection of FAc after a suboptimal response to prior combinations of DME treatments. Eyes were followed-up for 6.3±2.9 months. Effectiveness was assessed from the changes in best-corrected visual acuity (BCVA; ETDRS letters) and OCT measures of central foveal thickness (CFT).A budget-impact model was developed over a single 3-year dosing cycle for the FAc implant and based on local hospital patient data and prescribing patterns. This included 4 injections of ranibizumab per year and 2 injections of dexamethasone per year. These costs were compared with a single FAc implant over the same period of time and took account of monitoring costs and the cost of managing adverse events.
Sixty-four percent (18/28) eyes were pseudophakic and 36% (10/28) were phakic at baseline. All eyes had previously been treated with anti-VEGF (range, 0 to 15) and/or steroid (range, 0 to 5) with a mean number of injections of 7.3±4.2 and 1.8±1.4, respectively. At baseline, mean BCVA was 39.9±16.7 letters and mean CFT was 526.3±123.2 µm. Following FAc implant, mean BCVA increased by +11.3±8.6 letters and mean CFT decreased by 236.4±124.7 µm.The budget-impact model developed projected a total saving of 181,496€ over a 3-year period with the greatest savings from switching to the FAc implant occurring in years 2 and 3 (see Table).
FAc implant may offer continuous and sustained effectiveness leading to fewer injections per year and a reduction in the number of outpatient visits leading to cost-savings over a 3-year period.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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