College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates.
Independent Pharmacoeconomic Researcher, Cairo, Egypt.
Value Health Reg Issues. 2020 Sep;22:23-26. doi: 10.1016/j.vhri.2019.09.007. Epub 2020 Apr 1.
The standard-of-care treatment for age-related macular degeneration (AMD) and diabetic macular edema (DME) includes inhibiting blood vessel proliferation and reducing macular edema or swelling using anti-vascular endothelial growth factor therapies, such as ranibizumab and aflibercept. To conduct a cost-minimization analysis of ranibizumab and aflibercept for treating Saudi patients with visual impairment owing to AMD or DME.
Cost minimization was analyzed assuming that ranibizumab and aflibercept have equivalent clinical effectiveness. The third-party payer's perspective was used in several clinical scenarios. The base-case scenario was DME cases followed monthly using a protocol-specific follow-up. In scenario 1, AMD cases followed a treat-and-extend protocol over 2 years. In scenario 2, AMD cases followed the PRN (pro re nata) regimen over 2 years. In scenario 3, DME cases followed the PRN regimen for 1 year only.
Aflibercept yielded cost savings of 25.75%, 31.54%, 51.30%, and 9.28% compared with ranibizumab for the base case, scenario 1, scenario 2, and scenario 3, respectively, which supports the premise that aflibercept is more cost saving than ranibizumab.
From the third-party payer perspective, aflibercept is a cost-containment option that provides substantial savings over ranibizumab for treating Saudi patients with AMD or DME.
治疗年龄相关性黄斑变性（AMD）和糖尿病性黄斑水肿（DME）的标准治疗包括使用抗血管内皮生长因子治疗（如雷珠单抗和阿柏西普）抑制血管增生并减少黄斑水肿或肿胀。对雷珠单抗和阿柏西普治疗沙特因 AMD 或 DME 而视力受损的患者进行成本最小化分析。
假设雷珠单抗和阿柏西普具有等效的临床疗效，进行成本最小化分析。在几种临床情况下使用第三方支付者的观点。基础情况是每月根据具体方案对 DME 患者进行随访。在方案 1 中，AMD 患者遵循治疗和延长方案两年。在方案 2 中，AMD 患者遵循 PRN（按需）方案两年。在方案 3 中，DME 患者仅遵循 PRN 方案一年。
与雷珠单抗相比，阿柏西普在基础病例、方案 1、方案 2 和方案 3 中分别节省了 25.75%、31.54%、51.30%和 9.28%的成本，支持阿柏西普比雷珠单抗更节省成本的前提。
从第三方支付者的角度来看，阿柏西普是一种控制成本的选择，与雷珠单抗相比，为治疗沙特 AMD 或 DME 患者提供了大量节省。
