Cost and effectiveness of therapy for wet age-related macular degeneration in routine clinical practice

Authors

STUDNIČKA Jan ŘÍHOVÁ Barbora RENCOVÁ Eva ROZSÍVAL Pavel DUBSKÁ Zora CHRAPEK Oldřich KOLÁŘ Petr KANDRNAL Vít DEMLOVÁ Regina PITROVÁ Šárka ŘEHÁK Jiří

Year of publication 2013
Type Article in Periodical
Magazine / Source Ophthalmologica
MU Faculty or unit

Faculty of Medicine

Citation
Web http://www.karger.com/Article/Abstract/350802
Doi http://dx.doi.org/10.1159/000350802
Field ORL, ophthalmology, stomatology
Keywords Age-related macular degeneration; Choroidal neovascular membrane; Ranibizumab; Pegaptanib; Photodynamic therapy with verteporfin; Cost-effectiveness
Description Purpose: Evaluation of the cost and effectiveness of therapy for patients with the wet form of age-related macular degeneration (AMD) in routine clinical practice. Methods: A retrospective multicentre evaluation of changes in the best-corrected visual acuity in applied kinds of therapy and a comparison with the cost of individual therapeutic procedures. Results: An overall total of 788 eyes of 763 patients with an average age of 73.2 +/- 8.6 years was evaluated for a 1-year minimum period. In the ranibizumab and pegaptanib therapy groups, a reduction of 1.3 letters (p = 0.303) and 1.4 letters (p = 0.197) was found, respectively. In the group of photodynannic therapy (PDT) with verteporfin, a reduction of 5.2 letters was achieved (p < 0.001). Under the conditions of routine practice in the Czech Republic, the annual cost is highest (EUR 5,467.63/patient) in patients with pegaptanib therapy. The annual cost in patients with ranibizumab therapy is lower by EUR 1,220.16. The cost is nearly half (EUR 2,783.65) in the group treated with PDT with verteporfin. Conclusion: An initiation of AMD therapy by ranibizumab is cost-effective as compared to pegaptanib. Both ranibizumab and pegaptanib are significantly more efficient as compared to PDT with verteporfin. Therapy with ranibizunnab and pegaptanib, as compared to PDT with verteporfin, prevents the loss of 1 line of vision on the ETDRS chart for EUR 1,225.98 and 2,286.18, respectively.

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