دورية أكاديمية
Cost-effectiveness of Aflibercept Monotherapy vs Bevacizumab First Followed by Aflibercept If Needed for Diabetic Macular Edema
| العنوان: | Cost-effectiveness of Aflibercept Monotherapy vs Bevacizumab First Followed by Aflibercept If Needed for Diabetic Macular Edema |
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| المؤلفون: | Hutton, David W., Glassman, Adam R., Liu, Danni, Sun, Jennifer K., Sneath, Mark, Chen, Melvin, Jelemensky, Peggy A., Miller, Rosa, Basham, Samantha R., Raphael, Tara L., Harara, Abla M, Berger, Brian B., Jhaveri, Chirag D., Stovall, Christopher C., Renfroe, Cori, Vega Pereira, Daniela, Wilson, Daniela Mariel, Makkouk, Fuad, Jonna, Gowtham, Gunderson, Ivana, Chexal, Saradha, Gatavaski, Valerie, Ren, Yong, Irons, Amber N, Rego, Brittany, Weinberg, David V., Dorsey, Eleanor, Nelson, Erika, Sheppard, Hannah, McKenney, Kaitlin C, Chen, Nickolas, Wirostko, William J., Ghuman, A. Thomas, Arevalo, Alice, Petersen, Amanda J., Leslie, Anita H., Sharma, Ashish G., Kiesel, Cheryl, Peters, Crystal Y., Knips, Eileen, Walker, Joseph P., Mears, Katrina A., Maro, Kristi, Toleman, Lee T, Raskauskas, Paul A., Kiesel, Raymond K., Meeks, Ashaki, Rhymes, Ginger K., Gardner, Glenn R, Shami, Michel |
| المصدر: | JAMA Ophthalmology ; volume 141, issue 3, page 268 ; ISSN 2168-6165 |
| بيانات النشر: | American Medical Association (AMA) |
| سنة النشر: | 2023 |
| الوصف: | Importance The DRCR Retina Network Protocol AC showed no significant difference in visual acuity outcomes over 2 years between treatment with aflibercept monotherapy and bevacizumab first with switching to aflibercept for suboptimal response in treating diabetic macular edema (DME). Understanding the estimated cost and cost-effectiveness of these approaches is important. Objective To evaluate the cost and cost-effectiveness of aflibercept monotherapy vs bevacizumab-first strategies for DME treatment. Design, Setting, and Participants This economic evaluation was a preplanned secondary analysis of a US randomized clinical trial of participants aged 18 years or older with center-involved DME and best-corrected visual acuity of 20/50 to 20/320 enrolled from December 15, 2017, through November 25, 2019. Interventions Aflibercept monotherapy or bevacizumab first, switching to aflibercept in eyes with protocol-defined suboptimal response. Main Outcomes and Measures Between February and July 2022, the incremental cost-effectiveness ratio (ICER) in cost per quality-adjusted life-year (QALY) over 2 years was assessed. Efficacy and resource utilization data from the randomized clinical trial were used with health utility mapping from the literature and Medicare unit costs. Results This study included 228 participants (median age, 62 [range, 34-91 years; 116 [51%] female and 112 [49%] male; 44 [19%] Black or African American, 60 [26%] Hispanic or Latino, and 117 [51%] White) with 1 study eye. The aflibercept monotherapy group included 116 participants, and the bevacizumab-first group included 112, of whom 62.5% were eventually switched to aflibercept. Over 2 years, the cost of aflibercept monotherapy was $26 504 (95% CI, $24 796-$28 212) vs $13 929 (95% CI, $11 984-$15 874) for the bevacizumab-first group, a difference of $12 575 (95% CI, $9987-$15 163). The aflibercept monotherapy group gained 0.015 (95% CI, −0.011 to 0.041) QALYs using the better-seeing eye and had an ICER of $837 077 per QALY gained compared with the ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1001/jamaophthalmol.2022.6142 |
| الإتاحة: | https://doi.org/10.1001/jamaophthalmol.2022.6142Test https://jamanetwork.com/journals/jamaophthalmology/articlepdf/2801005/jamaophthalmology_hutton_2023_oi_220091_1678899617.45136.pdfTest |
| رقم الانضمام: | edsbas.337E8008 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1001/jamaophthalmol.2022.6142 |
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