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Retina

Medication drives cost associated with DME treatment

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In a cost analysis of the treatment of diabetic macular edema (DME) with bevacizumab-first (step therapy) compared to aflibercept monotherapy, medication costs accounted for 73% and 82%, respectively, at 2 years.

As a result of the percentage number of patients who switch from bevacizumab-first step therapy to aflibercept, the cost savings associated with bevacizumab therapy was not as great as anticipated.

For the cost analysis, researchers used 2 years of published data from the Diabetic Retinopathy Clinical Research Network (DRCR.net) protocol AC. Costs were modeled based on 2022 Medicare reimbursement data and results were extrapolated to estimate lifetime (17 years for the age of the cohort) cost.

In the aflibercept monotherapy group:
-Cost to treat in the facility (nonfacility setting): $42,000 ($32,000)
-Extrapolated modeled lifetime costs: $158,000 ($136,000)

In the bevacizumab-first group
-Cost to treat in the facility (nonfacility setting): $29,000 ($22,000)
-Extrapolated modeled lifetime costs: $125,000 ($103,000)

At year 2 and year 17, the total cost with bevacizumab-first was 33% and 21% lower than with aflibercept monotherapy, respectively, and the annual savings were $6,500 ($5000) and $1900 ($1900) in the facility (non-facility) setting, respectively.

Reference
Patel NA, Al-Khersan H, Yannuzzi NA, et al. Aflibercept Monotherapy versus Bevacizumab First for Diabetic Macular Edema: A Cost Analysis based on DRCR Protocol AC Results. Ophthalmol Retina. 2022;S2468-6530(22)00576-0. doi: 10.1016/j.oret.2022.11.010. Epub ahead of print. PMID: 36423893.

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