Anti-VEGF Cost Analysis: Implant Versus Injections
By Jean Shaw
Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
Journal Highlights
JAMA Ophthalmology, July 2022
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How do costs of the ranibizumab port delivery system (PDS) compare with intravitreal injections of anti-VEGF agents for the treatment of neovascular age-related macular degeneration (AMD)? Sood et al. addressed this question in a cost analysis study. They found that the PDS costs more than intravitreal injections of ranibizumab and aflibercept under certain treatment scenarios. Bevacizumab injections were less costly than the PDS under all scenarios studied.
The authors used data from two clinical trials of the PDS and Medicare reimbursement rates. Main outcome measures included the number of intravitreal ranibizumab, aflibercept, and bevacizumab injections needed to break even with the cost of the PDS.
Results showed that the mean number of anti-VEGF injections needed to break even with the PDS was as follows:
- It took a mean of 6.4 ranibizumab, 5.5 aflibercept, and 34.5 bevacizumab injections to break even with the cost of the initial implantation of the PDS with medication.
- It took a mean of 10.8, 9.3, and 58.1 injections of ranibizumab, aflibercept, and bevacizumab, respectively, to break even with the cost of the PDS and one refill.
- A mean of 15.2 ranibizumab, 13.1 aflibercept, and 81.6 bevacizumab injections were needed to break even with the cost of the PDS with two refills at six-month intervals.
- To break even with the cost of an additional PDS refill, a mean of 4.4 ranibizumab, 3.8 aflibercept, and 23.6 bevacizumab injections were needed.
The authors noted that use of the PDS will rest on “other factors than cost, including safety, preferred practice, and willingness to undergo a surgery with frequent clinic visits.” (Also see related commentary by Shriji Patel, MD, MBA, and Paul Sternberg Jr., MD, in the same issue.)
The original article can be found here.