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Cost effectiveness of treatments for wet age-related macular degeneration

Paul Mitchell, Lieven Annemans UGent, Richard White, Meghan Gallagher and Simu Thomas (2011) PHARMACOECONOMICS. 29(2). p.107-131
abstract
Age-related macular degeneration (AMD) is a leading cause of blindness in people aged >= 50 years. Wet AMD in particular has a major impact on patient quality of life and imposes substantial burdens on healthcare systems. This systematic review examined the cost-effectiveness data for current therapeutic options for wet AMD. PubMed and EMBASE databases were searched for all articles reporting original cost-effectiveness analyses of wet AMD treatments. The Centre for Reviews and Dissemination and Cochrane Library databases were searched for all wet AMD health technology assessments (HTAs). Overall, 44 publications were evaluated in full and included in this review. A broad range of cost-effectiveness analyses were identified for the most commonly used therapies for wet AMD (pegaptanib, ranibizumab and photodynamic therapy [PDT] with verteporfin). Three studies evaluated the cost effectiveness of bevacizumab in wet AMD. A small number of analyses of other treatments, such as laser photocoagulation and antioxidant vitamins, were also found. Ranibizumab was consistently shown to be cost effective for wet AMD in comparison with all the approved wet AMD therapies (four of the five studies identified showed ranibizumab was cost effective vs usual care, PDT or pegaptanib); however, there was considerable variation in the methodology for cost-effectiveness modelling between studies. Findings from the HTAs supported those from the PubMed and EM BASE searches; of the seven HTAs that included ranibizumab, six (including HTAs for Australia, Canada and the UK) concluded that ranibizumab was cost effective for the treatment of wet AMD; most compared ranibizumab with PDT and/or pegaptanib. By contrast, HTAs at best generally recommended pegaptanib or PDT for restricted use in subsets of patients with wet AMD. In the literature analyses, pegaptanib was found to be cost effective versus usual/best supportive care (including PDT) or no treatment in one of five studies; the other four studies found pegaptanib was of borderline cost effectiveness depending on the stage of disease and time horizon. PDT was shown to be cost effective versus usual/best supportive care or no treatment in five of nine studies; two studies showed that PDT was of borderline cost effectiveness depending on baseline visual acuity, and two showed that PDT was not cost effective. We identified no robust studies that properly evaluated the cost effectiveness of bevacizumab in wet AMD.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
INTRAVITREAL RANIBIZUMAB LUCENTIS, PHOTODYNAMIC THERAPY, UTILITY ANALYSIS, VISUAL-ACUITY, LASER PHOTOCOAGULATION, CONTRAST SENSITIVITY, NONMEDICAL COSTS, VERTEPORFIN, BEVACIZUMAB, SUBFOVEAL CHOROIDAL NEOVASCULARIZATION
journal title
PHARMACOECONOMICS
Pharmacoeconomics
volume
29
issue
2
pages
107 - 131
Web of Science type
Review
Web of Science id
000287271700003
JCR category
ECONOMICS
JCR impact factor
2.663 (2011)
JCR rank
20/320 (2011)
JCR quartile
1 (2011)
ISSN
1170-7690
DOI
10.2165/11585520-000000000-00000
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2014790
handle
http://hdl.handle.net/1854/LU-2014790
date created
2012-02-01 13:37:39
date last changed
2016-12-19 15:42:12
@article{2014790,
  abstract     = {Age-related macular degeneration (AMD) is a leading cause of blindness in people aged {\textrangle}= 50 years. Wet AMD in particular has a major impact on patient quality of life and imposes substantial burdens on healthcare systems. This systematic review examined the cost-effectiveness data for current therapeutic options for wet AMD. PubMed and EMBASE databases were searched for all articles reporting original cost-effectiveness analyses of wet AMD treatments. The Centre for Reviews and Dissemination and Cochrane Library databases were searched for all wet AMD health technology assessments (HTAs). Overall, 44 publications were evaluated in full and included in this review. A broad range of cost-effectiveness analyses were identified for the most commonly used therapies for wet AMD (pegaptanib, ranibizumab and photodynamic therapy [PDT] with verteporfin). Three studies evaluated the cost effectiveness of bevacizumab in wet AMD. A small number of analyses of other treatments, such as laser photocoagulation and antioxidant vitamins, were also found. Ranibizumab was consistently shown to be cost effective for wet AMD in comparison with all the approved wet AMD therapies (four of the five studies identified showed ranibizumab was cost effective vs usual care, PDT or pegaptanib); however, there was considerable variation in the methodology for cost-effectiveness modelling between studies. Findings from the HTAs supported those from the PubMed and EM BASE searches; of the seven HTAs that included ranibizumab, six (including HTAs for Australia, Canada and the UK) concluded that ranibizumab was cost effective for the treatment of wet AMD; most compared ranibizumab with PDT and/or pegaptanib. By contrast, HTAs at best generally recommended pegaptanib or PDT for restricted use in subsets of patients with wet AMD. In the literature analyses, pegaptanib was found to be cost effective versus usual/best supportive care (including PDT) or no treatment in one of five studies; the other four studies found pegaptanib was of borderline cost effectiveness depending on the stage of disease and time horizon. PDT was shown to be cost effective versus usual/best supportive care or no treatment in five of nine studies; two studies showed that PDT was of borderline cost effectiveness depending on baseline visual acuity, and two showed that PDT was not cost effective. We identified no robust studies that properly evaluated the cost effectiveness of bevacizumab in wet AMD.},
  author       = {Mitchell, Paul and Annemans, Lieven and White, Richard and Gallagher, Meghan and Thomas, Simu},
  issn         = {1170-7690},
  journal      = {PHARMACOECONOMICS},
  keyword      = {INTRAVITREAL RANIBIZUMAB LUCENTIS,PHOTODYNAMIC THERAPY,UTILITY ANALYSIS,VISUAL-ACUITY,LASER PHOTOCOAGULATION,CONTRAST SENSITIVITY,NONMEDICAL COSTS,VERTEPORFIN,BEVACIZUMAB,SUBFOVEAL CHOROIDAL NEOVASCULARIZATION},
  language     = {eng},
  number       = {2},
  pages        = {107--131},
  title        = {Cost effectiveness of treatments for wet age-related macular degeneration},
  url          = {http://dx.doi.org/10.2165/11585520-000000000-00000},
  volume       = {29},
  year         = {2011},
}

Chicago
Mitchell, Paul, Lieven Annemans, Richard White, Meghan Gallagher, and Simu Thomas. 2011. “Cost Effectiveness of Treatments for Wet Age-related Macular Degeneration.” Pharmacoeconomics 29 (2): 107–131.
APA
Mitchell, P., Annemans, L., White, R., Gallagher, M., & Thomas, S. (2011). Cost effectiveness of treatments for wet age-related macular degeneration. PHARMACOECONOMICS, 29(2), 107–131.
Vancouver
1.
Mitchell P, Annemans L, White R, Gallagher M, Thomas S. Cost effectiveness of treatments for wet age-related macular degeneration. PHARMACOECONOMICS. 2011;29(2):107–31.
MLA
Mitchell, Paul, Lieven Annemans, Richard White, et al. “Cost Effectiveness of Treatments for Wet Age-related Macular Degeneration.” PHARMACOECONOMICS 29.2 (2011): 107–131. Print.