Cost Advantage of Fluocinolone Acetonide Implant (ILUVIEN®) versus Ranibizumab in the Treatment of Chronic Diabetic Macular Oedema

Visual Acuity Outcomes in Diabetic Macular Edema With Fluocinolone Acetonide 0.2 μg/Day Versus Ranibizumab Plus Deferred Laser (DRCR Protocol I)

“…An economic benefit may also be observed as a result of better DME management and fewer treatments. 25…”

A cost analysis comparing continued 3-year aflibercept monotherapy versus a switch from aflibercept to the fluocinolone acetonide intravitreal implant in phakic patients with chronic diabetic macular edema

“…In scenario 1, the model assumed that, after the initial loading dose of aflibercept (five injections), patients received an additional nine injections and follow-up visits; that is, a total of 14 aflibercept injections and 14 follow-up visits over the 3-year period. This assumption was based on the injection numbers published in the analysis by Quhill and Beiderbeck [21], which reported a median of 14 anti-VEGF (ranibizumab) injections over a 3-year period (a median of seven, four, and three injections in years 1, 2, and 3, respectively). These numbers are also consistent with those reported for aflibercept in randomized controlled trials [22].…”

“…In routine clinical practice, the number of anti-VEGF injections is likely to be lower than the licensed posology, as shown in the POLARIS study [7], where the mean number of injections in year 1 was 4.9; however, outcomes in that study were suboptimal in comparison with other randomised controlled trials. Injection numbers were modeled to decrease [21] in years 2 and 3 to account for treat-and-extend dosing regimens [23].…”

“…Breakdown of cost calculations included in the model. injection each year; this assumption was based on an audit of the patients included in the analysis by Quhill and Beiderbeck [21]. The costs of monitoring the patient include the cost of 18 follow-up appointments with OCT retinal imaging and that of managing adverse events.…”

“…These cost assumptions were used to calculate the average cost of treating a single phakic eye over 3 years, and a hypothetical cohort of 30 patients with DME and a phakic eye (number based on the cohort of patients reported by Quhill and Beiderbeck [21]). In addition, a breakpoint analysis was performed to illustrate the impact on cost of treating different proportions of patients with continued aflibercept or the FAc intravitreal implant.…”