Document Detail


A United Kingdom-based Economic Evaluation of Ranibizumab for Patients with Retinal Vein Occlusion (RVO).
MedLine Citation:
PMID:  24673384     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: This study compares the cost-effectiveness of intravitreal ranibizumab versus observation and/or laser photocoagulation for treatment of macular oedema secondary to retinal vein occlusion in a UK-based model. Methods: A Markov model was constructed using transition probabilities and frequency of adverse events derived using data from the BRAVO, CRUISE and HORIZON trials. Outcomes associated with treatments and health states were combined to predict overall health costs and outcomes for cohorts treated with each option. Results: In branch retinal vein occlusion, ranibizumab produced a gain of 0.518 quality-adjusted life years at an incremental cost of £8141, compared with laser photocoagulation. The incremental cost-effectiveness ratio was £15 710 per quality-adjusted life year, and the incremental cost per month free from blindness was £658. In central retinal vein occlusion, ranibizumab produced a gain of 0.539 quality-adjusted life years at an incremental cost of £9216, compared with observation only. The incremental cost-effectiveness ratio was £17 103, and the incremental cost per month free from blindness was £423. Conclusions: These incremental cost-effectiveness ratios are below the £20 000-30 000 range typically accepted as a threshold for cost-effectiveness. This suggests that ranibizumab may be regarded as a cost-effective therapy for patients with macular oedema secondary to retinal vein occlusion, relative to grid laser photocoagulation (for BRVO) and observation (for CRVO). Limitations include sparse data for utilities associated with the severity of visual impairment in the WSE in patients with RVO. A lack of direct comparative evidence between ranibizumab and the dexamethasone intravitreal implant for the treatment of BRVO and CRVO and the infeasibility of an indirect comparison due to significant heterogeneity in trial designs prevented the inclusion of this treatment as a comparator in the Markov model. Abstract word count: 282; limit: 300.
Authors:
Matthew Taylor; Elçin Serbetci; Alberto Ferreira; Kerry Gairy; Lily Lewis; Julie Blouin; Paul Mitchell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-28
Journal Detail:
Title:  Journal of medical economics     Volume:  -     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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