Economic evaluation of bevacizumab versus ranibizumab in neovascular age-related macular degeneration

Objective To evaluate the cost-effectiveness of bevacizumab versus ranibizumab for patients with neovascular age-related macular degeneration ( AMD) in China.Methods A Markov model was constructed to compare cost per quality-adjusted life year of bevacizumab with ranibizumab in patients with neovascular AMD.In the Markov model, with cycle length of 3 months and time horizon of 10 years, three health states were defined by visual acuity.One way deterministic and probabilistic sensitivity analyses were conducted to explore the uncertainties from a number of variables.Results In the base case analysis , patients in ranibizumab group obtained 0.007 QALY more than patients in bevacizumab group , while the average total cost was ￥794 400 higher.The ICUR reached ￥109.23 million per QALY.In all sensitivity analyses, the ICURs were over ￥ 2.48 million per QALY between ranibizumab and bevacizumab groups. Conclusions Ranibizumab for neovascular AMD patients gained similar QALY at significantly higher costs in comparison with bevacizumab.The ICURs generated in this study were much higher than the possible QALY threshold in the society of China.Compared with ranibizumab , bevacizumab was cost-effective for neovascular AMD patients. Key words: Neovascular age-related macular degeneration ;  Economic evaluation ;  Vascular endothelial growth factor ;  Bevacizumab ;  Ranibizumab ;