PSS10 Cost- Effectiveness of Ranibizumab in Patients with Neovascular Wet Age-Related Macular Degeneration (Namd) at the Mexican Social Security System (Imss)

Abstract

OBJECTIVES: Describe costs and utilization patterns of corticosteroid (CTS), immunosuppressive (IMS), and biologic (BIO) treatment use in patients with chronic non-infectious uveitis. Costs and utilization of CTS, IMS and BIO indicate economic burden but have not been studied in a large sample. METHODS: Patients with 31 NPSU diagnosis (ICD-9-CM 360.x-364.x, excluding infectious uveitis) by an ophthalmologist or 32 by a primary care physician, under age 65, with continuous insurance coverage during a six-month baseline were selected from a privately insured claims database (Nϭ80.7 million). Sample index dates were defined as the first prescription/administration of CTS, IMS, or BIO between 2003-2009. CTS patients had 32 10-day or 31 30-day scripts. Analysis was in a per-member-per-month (PMPM) framework based on treatment episodes, defined as continuous medication use within the same class. Wilcoxon rank-sum and chi-square tests were used for comparisons of costs and categorical outcomes. RESULTS: CTS (Nϭ19,426), IMS (Nϭ5,466) and BIO (Nϭ1,694) samples were selected; average time on continuous therapy (i.e., treatment episode duration) was 1.79, 3.66, and 8.18 months (pϽ0.05 across groups). Baseline Charlson Comorbidity Index was highest for BIO (0.83), then IMS (0.78), then CTS (0.039) (pϽ0.05 across groups). Baseline PMPM inpatient admission rates were 0.021 for CTS, 0.044 for IMS, and 0.045 for BIO (pϽ0.05 across groups); study period values were 0.032, 0.048, and 0.024, respectively (pϽ0.05 CTS different vs. both). Emergency room visits had a similar ordering.