Comparison of Outcomes and Costs of Ranibizumab and Aflibercept Treatment in Real-Life

• Published in: PloS one 2015-08, Vol.10 (8), p.e0135050-e0135050
• Main Authors: Schmid, Martin K, Reich, Oliver, Faes, Livia, Boehni, Sophie C, Bittner, Mario, Howell, Jeremy P, Thiel, Michael A, Signorell, Andri, Bachmann, Lucas M
• Format: Article
• Language: English
• Subjects: Acuity; Aflibercept; Age; Age related diseases; Aged; Ambulatory Care Facilities - statistics & numerical data; Comparative analysis; Comparative studies; Costs; Costs and Cost Analysis; Diabetes mellitus; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - economics; Drug therapy; Economic aspects; Edema; Ethics; Female; Health aspects; Health care; Health care costs; Health Care Costs - statistics & numerical data; Health care expenditures; Health sciences; Hospitals; Humans; Immunotherapy; Insurance Claim Review; Macular degeneration; Macular Degeneration - drug therapy; Macular Degeneration - economics; Macular Edema - drug therapy; Macular Edema - economics; Male; Monoclonal antibodies; Occlusion; Patient outcomes; Patients; Performance evaluation; Ranibizumab; Ranibizumab - economics; Ranibizumab - therapeutic use; Receptors, Vascular Endothelial Growth Factor - economics; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - economics; Recombinant Fusion Proteins - therapeutic use; Retina; Retinal Vein Occlusion - drug therapy; Retinal Vein Occlusion - economics; Tomography, Optical Coherence; Treatment Outcome; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0135050

Treatment efficacy and costs of anti-VEGF drugs have not been studied in clinical routine. To compare treatment costs and clinical outcomes of the medications when adjusting for patients' characteristics and clinical status. Comparative study. The largest public ophthalmologic clinic in Switzerland. Health care claims data of patients with age-related macular degeneration, diabetic macula edema and retinal vein occlusion were matched to clinical and outcome data. Patients' underlying condition, gender, age, visual acuity and retinal thickness at baseline and after completing the loading phase, the total number of injections per treatment, the visual outcome and vital status was secured. We included 315 patients (19595 claims) with a follow-up time of 1 to 99 months (mean 32.7, SD 25.8) covering the years 2006-2014. Mean age was 78 years (SD 9.3) and 200 (63.5%) were female. At baseline, the mean number of letters was 55.6 (SD 16.3) and the central retinal thickness was 400.1 μm (SD 110.1). Patients received a mean number of 15.1 injections (SD 13.7; range 1 to 85). Compared to AMD, adjusted cost per month were significantly higher (+2174.88 CHF, 95%CI: 1094.50-3255.27; p