Cost-minimization Analysis of Ranibizumab versus Aflibercept in the Treatment of Neovascular Age-related Macular Degeneration in Colombia

ABSTRACT

Background

In 2020 Colombia may expect to have close to 231,700 patients with neovascular age-related macular degeneration (ARMD). Treatment of neovascular ARMD involves the sequential Intra-vitreal injections of anti-vascular endothelial growth factor (anti-VEGF therapy) medications. The efficacy and safety of anti-VEGF therapy on a treat-and-extend (T&E) dosing scheme are similar when ranibizumab or aflibercept are administered. Objective: A cost-minimization analysis from the payer`s perspective in Colombia projects treatment expenses of anti-VEGF therapy using aflibercept or ranibizumab on T&E regimens for the treatment of neovascular ARMD. Methods: A model projects the expenses of the compared treatment regimens for two and five-year periods beginning on February 2020. The model used information from clinical trials, case series and meta-analyses on the compared treatment regimens, demographic, epidemiologic and economic data originated from the Colombian government sources. A 3% discount rate was applied. Results: Projected cost differences in favor of ranibizumab after two and five-year treatment periods beginning February 2020 could be close to U.S. $ 4,861 and U.S $ 7,241 per treated eye, respectively. If all patients with unilateral and bilateral neovascular ARMD in Colombia were to receive appropriate anti-VEGF therapy for two years, the projected expected cost difference in favor of ranibizumab could be close to U.S. $ 462,717,092 dollars. Conclusion: Within the Colombian healthcare setting anti-VEGF therapy on a T&E regimen utilizing ranibizumab for neovascular ARMD may be cost-saving compared with employing aflibercept. Despite cost favorability, ranibizumab should not be the only therapeutic option since in clinical practice alternatives are required.

KEYWORDS:

• age-related macular degeneration,
• macula,
• macular degeneration,
• cost-minimization analysis,
• anti-angiogenic therapy,
• anti-VEGF therapy,
• ranibizumab,
• aflibercept,
• pharmaco-economic analysis

This study has not been published anywhere previously and is not simultaneously being considered for review by any other publication

Declaration on interest

The author has been a speaker for Abbott, Novartis, Novo Nordisk and a clinical researcher for Merck. The author did not receive any funding, financial or any kind of support from any party for the development of this study. The total expenses for this study are entirely covered by the author.