Cost-effectiveness of Intravitreal Ranibizumab With Verteporfin Photodynamic Therapy Compared With Ranibizumab Monotherapy for Patients With Polypoidal Choroidal Vasculopathy

Doble, Brett; Finkelstein, Eric A.; Tian, Yubing; Saxena, Nakul; Patil, Shrikant; Wong, Tien Yin; Cheung, Chui Ming Gemmy

doi:10.1001/jamaophthalmol.2019.5628

Cited by 7 publications

(13 citation statements)

References 27 publications

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“…Doble et al have shown that combination therapy (PDT + Intravitreal Ranibizumab) is more effective and less costly than Ranibizumab monotherapy during a lifetime horizon. [ 17 ] However, if the time horizon was reduced to less than 10 years and/or reduction in cost of monotherapy was done, then combination therapy was no longer cost-effective.…”

Section: Discussionmentioning

confidence: 99%

Vitreoretinal Society of India practice pattern survey 2020: Medical retina

Sheth

Gopal

Gillies

et al. 2021

Indian Journal of Ophthalmology

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Purpose: The aim of this study was to present the outcomes of the Vitreo-retinal Society of India (VRSI) Practice Pattern Survey 2020 in medical retina. Methods: An online survey of members of VRSI was conducted in April 2020 regarding their practice-patterns on varied medical and surgical retina topics concerning imaging and management approach. The results were evaluated by two independent experts in this field and compared with the evidence and other practice patterns in the world. Results: A total of 107 VRSI members participated in the online survey. Responses were obtained on management of wide-ranging chorioretinal disorders such as Central Serous Chorioretinopathy (CSCR), Polypoidal Choroidal Vasculopathy (PCV), Neovascular age related macular degeneration (n-AMD), Retinal Vein Occlusions (RVO), and Diabetic Retinopathy (DR). Participants were also surveyed regarding their attitudes and perceptions about anti-VEGF practice patterns and role of imaging in their current practice. Each of the survey question responses were then compared to contemporary literature, including evidence-based guidelines, randomized controlled trials (RCTs), real-world evidence and analogous international surveys. Comprehensive analysis related to this has been put forward in the article. Conclusion: This survey represents the contemporary practice patterns amongst vitreoretinal specialists in India. The survey results are vital for fellow practitioners to understand the 'standard of care’ practice in medical retina. This will guide them to devise the best possible individualized treatment strategy for most favorable clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Vitreoretinal Society of India practice pattern survey 2020: Medical retina

Sheth

Gopal

Gillies

et al. 2021

Indian Journal of Ophthalmology

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“… 9–11 Despite economic evaluations have played a crucial role in decision-making on the value for money of high-cost medications, there was a few economic evaluations determining the cost-utility of the PCV treatments. 17 , 22 , 23 This study is the first CUA of PCV treatments conducted in Thailand under both societal and payer perspectives over the lifetime horizon. We employed two-year clinical and resources used data from the two landmark RCTs, the EVEREST II 9 , 10 and PLANET 18 , 19 studies.…”

Section: Discussionmentioning

confidence: 99%

Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand

Sangroongruangsri¹,

Chaikledkaew²,

Hanusaha³

et al. 2021

CEOR

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“…Doble et al assessed the incremental cost-effectiveness of combination therapy compared with ranibizumab monotherapy. They found that combination therapy had similar costs but was slightly more effective than ranibizumab monotherapy over a lifetime [38].…”

Section: Discussionmentioning

confidence: 99%

“…To date, there is no firm evidence addressing whether performing PDT during anti-VEGF therapy is cost-effective. However, considering the superior cost-effectiveness of combination therapy demonstrated in previous studies [8,9,38], it is possible that the number of anti-VEGF injections can be reduced by administering combination therapy after the first lesion reactivation. Further studies are required to verify this.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Switching from Fixed-Dose to As-Needed Regimen for Treating Submacular Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy

Kim¹,

Kim²,

Kim³

et al. 2020

JCM

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Background: The aim of this study was to evaluate outcomes in patients with submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV) after switching treatment from a fixed-dose to an as-needed regimen. Methods: This retrospective study included 19 patients with submacular hemorrhage secondary to PCV who were treated with fixed-dose intravitreal aflibercept during the first 56 weeks. After 56 weeks, the treatment regimen was switched to an as-needed regimen. The incidence and timing of lesion reactivation during the as-needed phase were evaluated. The best-corrected visual acuity (BCVA) at baseline (beginning of the regimen) and the final follow-up were compared. Multivariate analysis was performed to determine the factors associated with lesion reactivation. Results: During the mean follow-up period of 27 ± 7.3 months, lesion reactivation was noted in 10 patients (52.6%; mean time period: 12.2 ± 9.1 months) in the as-needed phase. Reactivations were treated with anti-vascular endothelial growth factor (VEGF) injections (mean, 4.1 ± 2.6). The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 0.26 ± 0.34 at baseline and 0.31 ± 0.38 at final follow-up (p = 0.212). Deterioration of ≥0.2 logMAR BCVA was noted in two patients (10.5%). In multivariate analysis, large lesion size was closely associated with a high risk of lesion reactivation (p = 0.009). Conclusion: Visual acuity was relatively stable after switching from a fixed-dose to an as-needed regimen, with no definite visual deterioration in the majority of patients. We conclude that patients with large lesions should be carefully monitored when switching to an as-needed regimen.

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Cost-effectiveness of Intravitreal Ranibizumab With Verteporfin Photodynamic Therapy Compared With Ranibizumab Monotherapy for Patients With Polypoidal Choroidal Vasculopathy

Cited by 7 publications

References 27 publications

Vitreoretinal Society of India practice pattern survey 2020: Medical retina

Vitreoretinal Society of India practice pattern survey 2020: Medical retina

Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand

Long-Term Outcomes of Switching from Fixed-Dose to As-Needed Regimen for Treating Submacular Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy

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