Pharmacoeconomic Evaluation of Anti-VEGF Drugs and Laser Photocoagulation for The Treatment of DME in China / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the cost-effectiveness of ranibizumab and aflibercept compared with laser photocoagulation for the treatment of diabetic macular edema (DME) from Chinese societal perspective. METHODS: A Markov model was constructed to simulate the long-term outcomes and costs of treating DME. Transition probabilities were calculated from the raw data of randomized controlled trial and published network Meta-analysis. Health state utilities were estimated through literature, and costs were estimated from experts consultation of 6 hospitals in China and published literature. The primary outcomes of the model were costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Uncertainty was addressed via univariate and probabilistic sensitivity analyses. RESULTS: The ICER comparing ranibizumab with laser photocoagulation was 61 174•QALY-1, comparing aflibercept with laser photocoagulation was 138 232•QALY-1. Based on the generally accepted ICER threshold of 3 times per-capita GDP (59 660, 2017 China), ranibizumab and aflibercept were found to be cost-effective compared with laser photocoagulation. Comparing ranibizumab with aflibercept, ranibizumab was the dominant therapy, with an incremental gain of 0.03 QALYs and cost savings of 22 053. Univariate and probabilistic sensitivity analysis demonstrated the robustness of the results. CONCLUSION: Compared with laser photocoagulation, ranibizumab and aflibercept are the cost-effective treatment for DME; compared with aflibercept, ranibizumab is the dominant treatment for DME.