Abstract
Purpose :
We aimed to determine the cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection (VEGF) compared to panretinal photocoagulation (PRP) in patients with proliferative diabetic retinopathy (PDR).
Methods :
We assessed cost-effectiveness by simulating four treatment strategies using PRP and the anti-VEGF injection by constructing a Markov model for a hypothetical cohort of fifty-year-old PDR patients. Four treatment Interventions are as follows: (1) PRP only (covered by South Korea’s National Health Insurance Service [NHIS]); (2) the anti-VEGF injection only; (3) PRP first; and (4) the anti-VEGF injection first for PDR treatment. We used main outcomes as the incremental cost-effectiveness ratio (ICER) of the other three strategies compared to the PRP only strategy.
Results :
In this cost-effectiveness analysis, the ICER, compared to the PRP only strategy, was $95,456 per quality-adjusted life-year (QALY) for the PRP first strategy, $34,375 per QALY for the anti-VEGF injection first strategy, and $33,405 per QALY for the anti-VEGF injection only strategy from a healthcare perspective. From the societal and payer perspective, the anti-VEGF injection only strategy was the most cost-saving and most effective tactic compared to the PRP only strategy. In the probabilistic sensitivity analysis, the PRP only strategy was cost-effective up to the willingness-to-pay (WTP) of about $42,000, while the anti-VEGF injection only strategy was cost-effective thereafter from a healthcare perspective. From the societal and payer perspectives, regardless of the value of WTP, the anti-VEGF injection only strategy was the most cost-effective one.
Conclusions :
The anti-VEGF injection only strategy for PDR was cost-effective from the societal and payer perspectives. Hence, our results on the cost-effectiveness of the anti-VEGF injection for PDR, alone or in combination with PRP treatment, can be used as important evidence when making medical service decisions.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.