WHAT IS THE CADTH REIMBURSEMENT RECOMMENDATION FOR VABYSMO?: CADTH recommends that Vabysmo be reimbursed by public drug plans for the treatment of neovascular (wet) age-related macular degeneration (nAMD) if certain conditions are met. WHICH PATIENTS ARE ELIGIBLE FOR COVERAGE? Vabysmo should only be covered to treat patients with nAMD, as per the approved Health Canada indication. WHAT ARE THE CONDITIONS FOR REIMBURSEMENT? Vabysmo should only be reimbursed if prescribed by an ophthalmologist with experience managing nAMD and if the cost per administration is not more than the least costly drug covered by the public drug plans for the treatment of nAMD. WHY DID CADTH MAKE THIS RECOMMENDATION? Evidence from 2 clinical trials demonstrated that Vabysmo is no worse than Eylea in maintaining or improving clearness or sharpness of vision in patients with nAMD. Patients with nAMD identified a need for new treatments that require fewer injections. Although Vabysmo can be given at an interval of up to every 16 weeks, there is not enough evidence to prove that treatment with Vabysmo results in fewer injections than other treatments for nAMD. There is not enough evidence to suggest Vabysmo works better than other drugs that are covered by the public drug plans for patients with nAMD. Therefore, the price of Vabysmo should not be more than the lowest-cost drug covered by the public drug plans to ensure that coverage does not increase drug plan budgets. Vabysmo may decrease costs for the public drug plans, but for this to occur, the price must be less than the lowest-cost drug covered by the plans.
WHAT IS NAMD? nAMD is an eye disease in which there is a leakage of blood and fluids from abnormal blood vessels formed under the central retina, which causes damage to the retina and irreversible loss of central vision. It is estimated that nAMD affects more than 150,000 people in Canada. UNMET NEEDS IN NAMD: Patients with nAMD expressed a need for new treatments for nAMD that require fewer injections. HOW MUCH DOES VABYSMO COST? Treatment with Vabysmo is expected to cost between $8,100 and $18,900 per patient in the first year of use depending on how many injections are required (between 6 and 14). In subsequent years, the annual cost per patient is expected to be between $4,050 and $17,550 as the number of injections required falls to between 3 and 13.
