%0 Journal Article
%T Bevacizumab vs. Ranibizumab in Preserving or Improving Vision in Patients with Wet, Age-Related Macular Degeneration: A Cost-effectiveness Review
%A Chukwuemeka C. Nwanze
%A Abumere Akinwale and Ron A. Adelman
%J Clinical Medicine Insights: Therapeutics
%D 2012
%I 
%R 10.4137/CMT.S7439
%X Objective: To evaluate the cost-effectiveness of monthly and as-needed dosing protocols using ranibizumab or bevacizumab for the treatment of neovascular age-related macular degeneration (AMD), when the treatment costs of severe ocular and systemic adverse events are considered. Methods: A Markov model was developed to assess the cost effectiveness of each of the following protocols: monthly ranibizumab, monthly bevacizumab, as-needed ranibizumab and as-needed bevacizumab. Direct costs and utilities were assessed from the perspective of a third-party payer or an insurance company. Cost effectiveness was evaluated in 2011 US dollars per quality-adjusted life year (QALY). Results: Considering the treatment costs of severe medical and ocular adverse events, the cost effectiveness of each protocol is as follows: monthly ranibizumab $63,333/QALY, ranibizumab as needed $18,571/QALY, bevacizumab monthly $2,676/QALY and bevacizumab as needed $3,333/QALY. Sensitivity analysis of the treatment costs of medical and ocular adverse events demonstrated minimal impact on relative cost-effectiveness. Conclusion: At current prices, monthly bevacizumab is the most cost-effective anti-VEGF AMD treatment protocol. Ranibizumab is as cost effective as bevacizumab at a maximum price of $158 per dose.
%U http://www.la-press.com/bevacizumab-vs-ranibizumab-in-preserving-or-improving-vision-in-patien-article-a3058