Cost analysis comparing adjuvant epimacular brachytherapy with anti-VEGF monotherapy for the management of neovascular age-related macular degeneration

Aims

To consider the cost implication of adopting epimacular brachytherapy (EMB) for the treatment of neovascular (wet) age-related macular degeneration (wAMD), compared with ranibizumab or bevacizumab monotherapy.

Methods

This analysis compared the cumulative 3-year costs of anti-VEGF (vascular endothelial growth factor) monotherapy to EMB combined with anti-VEGF therapy. Two patient groups were considered: newly diagnosed (treatment-naïve) patients; and patients already receiving chronic anti-VEGF therapy.

Results

In the treatment-naïve patients, the highest cumulative treatment costs were associated with ranibizumab monotherapy (£25 658), followed by bevacizumab monotherapy (£16 177), EMB with ranibizumab (£14 002), then EMB with bevacizumab (£10 289). In previously treated patients, the highest treatment costs were ranibizumab monotherapy (£18 355), followed by EMB with ranibizumab (£17 428), bevacizumab monotherapy (£16 177), then EMB with bevacizumab (£12 129).

Conclusion

EMB combined with anti-VEGF treatment has the potential to yield considerable cost savings, compared with anti-VEGF monotherapy. If the ongoing large studies of EMB confirm the published feasibility data, then adjuvant EMB may represent a cost-effective alternative to anti-VEGF monotherapy.