Cost analysis comparing adjuvant epimacular brachytherapy with anti-VEGF monotherapy for the management of neovascular age-related macular degeneration

Abstract

Aims: To consider the cost implication of adopting epimacular brachytherapy (EMB) for the treatment of neovascular (wet) age-related macular degeneration (wAMD), compared with ranibizumab or bevacizumab monotherapy.

Methods: This analysis compared the cumulative 3-year costs of anti-VEGF (vascular endothelial growth factor) monotherapy to EMB combined with anti-VEGF therapy. Two patient groups were considered: newly diagnosed (treatment-naïve) patients; and patients already receiving chronic anti-VEGF therapy.

Results: In the treatment-naïve patients, the highest cumulative treatment costs were associated with ranibizumab monotherapy (£25,658), followed by bevacizumab monotherapy (£16,177), EMB with ranibizumab (£14,002), then EMB with bevacizumab (£10,289). In previously treated patients, the highest treatment costs were ranibizumab monotherapy (£18,355), followed by EMB with ranibizumab (£17,428), bevacizumab monotherapy (£16,177), then EMB with bevacizumab (£12,129).

Conclusion: EMB combined with anti-VEGF treatment has the potential to yield considerable cost savings, compared with anti-VEGF monotherapy. If the ongoing large studies of EMB confirm the published feasibility data, then adjuvant EMB may represent a cost-effective alternative to anti-VEGF monotherapy.

Figure 1

Cumulative treatment costs over a 3-year projection, in treatment naïve patients.

Figure 2

Cumulative treatment costs over 3 years, in patients who had previously been treated with ranibizumab.