Krysanov I S, Klabukova D L, Krysanova V S, Ermakova V Yu
Russian University of Medicine, Moscow, Russia.
Medical Institute of Continuing Education of the BIOTECH University, Moscow, Russia.
Vestn Oftalmol. 2024;140(2):112-120. doi: 10.17116/oftalma2024140021112.
Diabetic macular edema (DME) is a degenerative disease of the macular area in diabetes mellitus and can lead to vision loss, disability, and significantly reduced quality of life. Faricimab is the only bispecific antibody for DME therapy that targets two pathogenic pathways (Ang-2 and VEGF-A).
This study comparatively evaluates the clinical and economic feasibility of faricimab and other angiogenesis inhibitors in patients with DME.
This article analyzed literature on the efficacy and safety of intravitreal injections (IVI) of ranibizumab 0.5 mg, aflibercept 2 mg, and faricimab 6 mg. A model of medical care was developed for patients with DME receiving anti-angiogenic therapy. Pharmacoeconomic analysis was performed using cost minimization and budget impact analysis (BIA) methods. Modeling time horizon was 2 years. The research was performed from the perspective of the healthcare system of the Russian Federation.
The efficacy and safety of faricimab in a personalized regimen (up to one IVI in 16 weeks) are comparable to those of aflibercept and ranibizumab, administered in various regimens. The use of faricimab is associated with the lowest number of IVIs. Over 2 years, the maximum costs of drug therapy were associated with the use of ranibizumab (about 914 thousand rubles), while the minimum costs were associated with the use of faricimab (614 thousand rubles). The reduction in inpatient care costs with faricimab therapy was 36% compared to aflibercept (216 and 201 thousand rubles in inpatient and day hospitals, respectively) and 82% compared to ranibizumab (486 and 451 thousand rubles in inpatient and day hospitals, respectively). BIA demonstrated that the use of faricimab will reduce the economic burden on the healthcare system by 11.3 billion rubles (9.8%) over 2 years.
The use of faricimab is a cost-effective approach to treatment of adult patients with DME in Russia.
糖尿病性黄斑水肿（DME）是糖尿病患者黄斑区的一种退行性疾病，可导致视力丧失、残疾，并显著降低生活质量。法西单抗是唯一一种用于DME治疗的双特异性抗体，可靶向两条致病途径（血管生成素-2和血管内皮生长因子-A）。
本研究比较评估了法西单抗和其他血管生成抑制剂在DME患者中的临床和经济可行性。
本文分析了玻璃体内注射0.5毫克雷珠单抗、2毫克阿柏西普和6毫克法西单抗的疗效和安全性的文献。为接受抗血管生成治疗的DME患者建立了医疗护理模型。使用成本最小化和预算影响分析（BIA）方法进行药物经济学分析。建模时间范围为2年。该研究是从俄罗斯联邦医疗保健系统的角度进行的。
法西单抗在个性化治疗方案（16周内最多一次玻璃体内注射）中的疗效和安全性与阿柏西普和雷珠单抗在各种治疗方案中的疗效和安全性相当。使用法西单抗的玻璃体内注射次数最少。在2年期间，药物治疗的最高成本与使用雷珠单抗相关（约91.4万卢布），而最低成本与使用法西单抗相关（61.4万卢布）。与阿柏西普相比，法西单抗治疗使住院护理成本降低了36%（住院和日间医院分别为21.6万和20.1万卢布），与雷珠单抗相比降低了82%（住院和日间医院分别为48.6万和45.1万卢布）。BIA表明，在2年期间，使用法西单抗将使医疗保健系统的经济负担减少113亿卢布（9.8%）。
在俄罗斯，使用法西单抗是治疗成年DME患者的一种具有成本效益的方法。
