Economic analysis of aflibercept in wet age-related macular degeneration

Objective. The aim of the study was to conduct clinical economic analysis of aflibercept (AFL) treatment compared to that of ranibizumab (RBZ) in patients with wet age-related macular degeneration (wAMD) in the Russian Federation Healthcare healthcare conditions. Materials and methods. Costs calculation was performed by means of simulation with a decision tree constructionmodel. The model was based on the results of clinical studies trials comparing the effectiveness efficacy of AFL and RBZ in patients with wAMD. Time horizon of the model was two years. Costs for the use of each drug in the model were calculated as the average of all possible states weighted according to their probability. Only direct medical costs were taken into account in this studyconsidered. These included costs of the drug, injection procedure, monthly treatment effect monitoring with in case of RBZ treatment, and laser photocoagulation therapy in case of angiogenesis inhibitors’ failure, as well as the costs associated with death. Probabilistic sensitivity analysis was conducted. Results. Total costs for 2 years of AFL therapy were less than with of RBZ: 626.077.12579 543,88 and 697 .264.,12 rubles per patient, respectively. Savings for 2 years favoring AFL equal were 71.187.00117 720,25 rubles per patient. The main factor determiningdriver of the results of in the baseline scenariobase case was fewer AFL injections number compared to RBZ during 2 years of treatment. Results were stable during sensitivity analysis. Conclusion. In the conditions of Russian Federation Healthcare, AFL has an economic advantage over RBZ in patients with wAMD and is the dominant alternative.