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Retina

Bevacizumab-first treatment strategy may be more cost-effective in DME

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Treatment with bevacizumab in eyes with vision loss from diabetic macular edema (DME) before switching to aflibercept in the case of poor response may provide substantial cost savings on a societal level, according to an article published in JAMA Ophthalmology.

Data from 228 participants of a randomized clinical trial with center-involved DME and best-corrected visual acuity of 20/50 to 20/320 were analyzed to evaluate costs related to aflibercept monotherapy (n = 116) versus bevacizumab-first strategies (n = 112). Overall, 62.5% of participants in the bevacizumab-first strategies switched to aflibercept.

Over the 2-year study period, aflibercept monotherapy cost $12 575 more than bevacizumab-first therapy ($26 504 vs $13 929), however, it had an incremental cost-effectiveness ratio of $837 077 per quality-adjusted life-year gained compared with bevacizumab first.

Reference
Hutton DW, Glassman AR, Liu D, et al; DRCR Retina Network. Cost-effectiveness of Aflibercept Monotherapy vs Bevacizumab First Followed by Aflibercept If Needed for Diabetic Macular Edema. JAMA Ophthalmol. Published online February 02, 2023. doi:10.1001/jamaophthalmol.2022.6142

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