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[Cost-utility analysis of ranibizumab (Lucentis) in neovascular macular degeneration].
Klin Monbl Augenheilkd. 2007 Sep; 224(9):727-32.KM

Abstract

PURPOSE

Ranibizumab (Lucentis) stabilizes or improves visual acuity in a high percentage of patients with age-related macular degeneration (AMD). As this therapy is associated with significant costs, the aim of this study was to provide a cost-utility analysis, which considers both costs and utility of a therapy with ranibizumab in an economic model.

METHODS

The incremental utility for the patient was modelled based on visual acuity data of the MARINA and ANCHOR study. The utility data used assume that the better seeing eye is affected. The study groups used for comparison consisted of patients who only received best supportive care, e. g., low-vision aids. The baseline scenario of the model assumes 6 treatments per year over a 2 year time period - based on the assessment of an expert panel. Treatment costs were based on German pharmacy prices and recommendations for reimbursement of the intravitreal injections. In a univariate sensitivity analysis all important parameters were varied to assess the stability of the results.

RESULTS

The baseline scenario yields for predominantly classic lesions 16,882 euro/QALY (quality adjusted life year), for minimally classic CNV 24,766 euro/QALY and for occult CNV 26,170 euro/QALY. If a distribution of the CNV types with 18 - 25 - 57 % is assumed, the mean cost of therapy with ranibizumab amounts to 24,147 euro/QALY. Sensitivity analysis showed that all reasonable variations yielded results which are considered cost-effective (<or= 50.000 US $/QALY). This is especially true for high and low patient age, for groups with low (0.05 - 0.1) and high (> 0.4) visual acuity, for a variation of costs per treatment of +/- 20 %, and a prolonged treatment duration of 3 years.

CONCLUSIONS

In the investigated szenario a therapy of neovascular AMD with ranibizumab is cost-effective for all angiographic subtypes as well as in the sensitivity analysis.

Authors+Show Affiliations

Augenklinik der Ludwig-Maximilians-Universität, München. aljoscha.neubauer@med.uni-muenchen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ger

PubMed ID

17846963

Citation

Neubauer, A S., et al. "[Cost-utility Analysis of Ranibizumab (Lucentis) in Neovascular Macular Degeneration]." Klinische Monatsblatter Fur Augenheilkunde, vol. 224, no. 9, 2007, pp. 727-32.
Neubauer AS, Holz FG, Schrader W, et al. [Cost-utility analysis of ranibizumab (Lucentis) in neovascular macular degeneration]. Klin Monbl Augenheilkd. 2007;224(9):727-32.
Neubauer, A. S., Holz, F. G., Schrader, W., Back, E. I., Kühn, T., Hirneiss, C., & Kampik, A. (2007). [Cost-utility analysis of ranibizumab (Lucentis) in neovascular macular degeneration]. Klinische Monatsblatter Fur Augenheilkunde, 224(9), 727-32.
Neubauer AS, et al. [Cost-utility Analysis of Ranibizumab (Lucentis) in Neovascular Macular Degeneration]. Klin Monbl Augenheilkd. 2007;224(9):727-32. PubMed PMID: 17846963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Cost-utility analysis of ranibizumab (Lucentis) in neovascular macular degeneration]. AU - Neubauer,A S, AU - Holz,F G, AU - Schrader,W, AU - Back,E I, AU - Kühn,T, AU - Hirneiss,C, AU - Kampik,A, PY - 2007/9/12/pubmed PY - 2007/12/27/medline PY - 2007/9/12/entrez SP - 727 EP - 32 JF - Klinische Monatsblatter fur Augenheilkunde JO - Klin Monbl Augenheilkd VL - 224 IS - 9 N2 - PURPOSE: Ranibizumab (Lucentis) stabilizes or improves visual acuity in a high percentage of patients with age-related macular degeneration (AMD). As this therapy is associated with significant costs, the aim of this study was to provide a cost-utility analysis, which considers both costs and utility of a therapy with ranibizumab in an economic model. METHODS: The incremental utility for the patient was modelled based on visual acuity data of the MARINA and ANCHOR study. The utility data used assume that the better seeing eye is affected. The study groups used for comparison consisted of patients who only received best supportive care, e. g., low-vision aids. The baseline scenario of the model assumes 6 treatments per year over a 2 year time period - based on the assessment of an expert panel. Treatment costs were based on German pharmacy prices and recommendations for reimbursement of the intravitreal injections. In a univariate sensitivity analysis all important parameters were varied to assess the stability of the results. RESULTS: The baseline scenario yields for predominantly classic lesions 16,882 euro/QALY (quality adjusted life year), for minimally classic CNV 24,766 euro/QALY and for occult CNV 26,170 euro/QALY. If a distribution of the CNV types with 18 - 25 - 57 % is assumed, the mean cost of therapy with ranibizumab amounts to 24,147 euro/QALY. Sensitivity analysis showed that all reasonable variations yielded results which are considered cost-effective (<or= 50.000 US $/QALY). This is especially true for high and low patient age, for groups with low (0.05 - 0.1) and high (> 0.4) visual acuity, for a variation of costs per treatment of +/- 20 %, and a prolonged treatment duration of 3 years. CONCLUSIONS: In the investigated szenario a therapy of neovascular AMD with ranibizumab is cost-effective for all angiographic subtypes as well as in the sensitivity analysis. SN - 0023-2165 UR - https://www.unboundmedicine.com/medline/citation/17846963/[Cost_utility_analysis_of_ranibizumab__Lucentis__in_neovascular_macular_degeneration]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-963470 DB - PRIME DP - Unbound Medicine ER -