PharmacoEconomics & Outcomes News 804, p6 - 2 Jun 2018 Bevacizumab most cost-effective treatment for AMD Although bevacizumab (Avastin) is not yet registered for age-related macular degeneration (AMD) in Europe, it appears to be most cost-effective treatment for the disease in Europe, according to findings of a study published in PLOS One. A decision-analytical model populated with data from a systematic review and meta-analysis was used to compare the cost effectiveness of bevacizumab as needed, ranibizumab (Lucentis) as-needed, and bimonthly aflibercept (Eylea) in patients with AMD, from a societal perspective in Europe over a one-year time horizon. Treatment with bevacizumab was estimated to cost €27 087 per year, and aflibercept and ranibizumab were estimated to cost approximately €4000 and €6000 more, respectively. All three drugs were similarly effective. Bevacizumab was therefore the most cost- effective therapy at a willingness-to-pay (WTP) threshold of €80 000 per QALY gained. It dominated ranibizumab (more or equally effective and less costly). The estimated incremental cost-effectiveness ratio for aflibercept versus bevacizumab was €278 099 per QALY gained. Aflibercept cost €943 per injection but the estimated maximum price at which aflibercept would be cost effective was €533 per injection at a WTP threshold of €80 000 per QALY gained, and £347 per injection at ** the NICE WTP threshold of £30 000 per QALY gained. The cost-effectiveness acceptibility curve showed that bevacizumab was likely to be the most cost effective treatment up to a WTP threshold of €407 250 per QALY gained. It was estimated that by using bevacizumab instead of aflibercept for AMD, Europe would save €335 million per yearly. "The registered drugs ranibizumab and aflibercept lead to large overspending without additional health benefits. Health authorities should consider taking steps to implement bevacizumab into clinical practice as first choice," concluded the authors. * 2014 euros ** National Institute for Health and Care Excellence (UK WTP threshold valued British pounds) van Asten F, et al. The cost-effectiveness of bevacizumab, ranibizumab and aflibercept for the treatment of age-related macular degeneration - A cost- effectiveness analysis from a societal perspective. PLOS One : 17 May 2018. Available from: URL: https://doi.org/10.1371/journal.pone.0197670 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804
PharmacoEconomics & Outcomes News – Springer Journals
Published: Jun 2, 2018
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