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.
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T Jackson has received research funding from NeoVista, Novartis, Oraya and Thrombogenics. He is on the advisory board of Bausch and Lomb, DORC and Oraya, and has been a consultant to Merck and NicOx. He has received conference support from DORC and NeoVista. S Prasad is a consultant for Bausch and Lomb, and Nidek. He has also received a conference support from Alcon, Allergan, and Novartis. L Kirkpatrick and Quorum Consulting received funding from NeoVista.
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Jackson, T., Kirkpatrick, L., Tang, G. et al. Cost analysis comparing adjuvant epimacular brachytherapy with anti-VEGF monotherapy for the management of neovascular age-related macular degeneration. Eye 26, 557–563 (2012). https://doi.org/10.1038/eye.2011.351
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DOI: https://doi.org/10.1038/eye.2011.351
