Background/aimsTo evaluate the cost-effectiveness of ranibizumab as either monotherapy or combined with laser therapy, compared with laser monotherapy, in the treatment of diabetic macular oedema (DME) causing visual impairment from a UK healthcare payer perspective.MethodsA Markov model simulated long-term outcomes and costs of treating DME in one eye (BCVA ≤75 letters) based on data from the RESTORE Phase III trial. Outcomes measured in quality-adjusted life-years (QALYs) were simulated for a 15-year time horizon based on 12-month follow-up from RESTORE and published long-term data. Costs included treatment, disease monitoring, visual impairment and blindness (at 2010 price levels).ResultsRanibizumab monotherapy resulted in a 0.17 QALY gain at an incremental cost of £4191 relative to laser monotherapy, yielding an incremental cost-effectiveness ratio (ICER) of £24 028. Probabilistic sensitivity analysis showed a 64% probability of being cost-effective at a threshold of £30 000 per QALY. Combined ranibizumab and laser therapy resulted in a 0.13 QALY gain at an incremental cost of £4695 relative to laser monotherapy (ICER £36 106; 42% probability of ICER <£30 000).ConclusionsBased on RESTORE 1-year follow-up data, ranibizumab monotherapy appears to be cost-effective relative to laser monotherapy, the current standard of care. Cost-effectiveness of combination therapy is less certain. Ongoing studies will further inform on disease progression and the need for additional ranibizumab treatment.

The application of treatment effect data derived from a Canadian cohort to the US setting was a limitation of the cost-effectiveness analysis. The findings of this cost-effectiveness analysis are not applicable to insulin-naïve diabetes patients.

were driven by drug and treatment costs associated with myocardial infarction. The total cost of saxagliptin/metformin XR group over 20 years was lower than SU plus MET treated group (US$ 14,454,257 vs. US$ 14,735,176). Treatment with saxagliptin/ metformin XR resulted in a greater number of quality-adjusted life years (QALYs) and life-years gained (LYG) than the SU combination (10,203 vs. 9,955 and 12,207 vs. 12,190 respectively). Cost-effectiveness results were robust according to sensitivity analysis. ConClusions: according to the model cost-effectiveness results in Colombia, saxagliptin/metformin XR FDC would be the dominant treatment option compared to SU as add-on to MET, for people with T2DM after failure of treatment only with MET. PDB62 Cost-effeCtiveness analysis of Canagliflozin (Cana) versus DaPagliflozin (DaPa) as an aDD-on to metformin (met) in Patients with tyPe 2 DiaBetes mellitus (t2Dm) in the uniteD states

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Bevacizumab (Avastin) is used, to investigate the effect of the correction of the poorer-seeing eye. We examined several scenarios of the poorer-seeing eye; no influence(0%), 10% and 20% influence of the utility of the better-seeing eye. In addition, it can be argued that treating the poorer-seeing eye has a preventive function, as it can become the future betterseeing eye. In the model a switch of the better-seeing eye is assumed after two and four years. RESULTS: By including the correction of the utility of the poorer-seeing eye the incremental cost-effectiveness ratio's (ICER) change from €5,260, €31,167 and €3,712, to respectively €10,375, €60,124 and €7,377 (20% influence). Lowering the influence from 20% to 0% has an effect of respectively, €13,706, €78,314 and €9,796. When inserting a switch at two and four years, the ICER reduces from €10,375, €60,124 and €7.377 to respectively €7,325, €53,649 and €4,848 at four years and almost half at 2 years. CONCLUSIONS: The results show that overestimating the QALY by excluding the poorer-seeing eye results in a lower incremental cost-effectiveness. Poorer-seeing eyes should be used when modeling eye-diseases. Whether the poorer-seeing eye contributes 20%, 10% or 0% has a small impact on the change in ICER's. The preventive function of treating the poorer-seeing eye should also be taken into account.