Dataset Information

Cost-effectiveness of intravitreal conbercept versus other treatments for wet age-related macular degeneration.

ABSTRACT:

Background

The potential benefits of conbercept, aflibercept, and ranibizumab has been reported in patients with wet age-related macular degeneration (wAMD). However, their economic outcomes are still unclear. The current study would assess the cost-effectiveness of conbercept, aflibercept and ranibizumab for patients with wAMD in a Chinese healthcare setting.

Methods

A Markov model was constructed based on patient visual acuity. Five regimens were considered: usual care without active anti-vascular endothelial growth factor (VEGF) treatment, IVT-AFL (intravitreal aflibercept on a two-monthly basis following three initial monthly doses), RBZ q4 (ranibizumab monthly dosing), RBZ RPN (ranibizumab dose as needed) and IVT-CON (intravitreal conbercept on a three-monthly basis after three initial monthly doses). Clinical, cost, and utility data were collected from published literature.

Results

In comparison with usual care, the IVT-AFL, RBZ q4, RBZ PRN, and IVT-CON strategies provided an additional 0.235, 0.338, 0.228, and 0.324 quality-adjusted life years (QALYs), respectively. They had marginal costs of $6,800, $10,084, $4,640, and $6,173, respectively. The strategies also produced incremental cost-effectiveness ratios (ICERs) of $28,892, $29,857, $20,338 and $19,028/QALY, respectively. One-way sensitivity analysis showed utility of blindness (best-corrected visual acuity <35) to have the greatest sensitivity of all the parameters. Probabilistic sensitivity analysis (PSA) indicated that IVT-CON yielded the greatest probabilities of cost-effectiveness (about 92%) compared with other strategies.

Conclusions

Conbercept is a cost-effective option for the treatment of wAMD in a Chinese healthcare setting.

SUBMITTER: Chen R

PROVIDER: S-EPMC7475432 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Cost-effectiveness of intravitreal conbercept versus other treatments for wet age-related macular degeneration.

Chen Rui R Wu Bin B

Annals of translational medicine 20200801 15

<h4>Background</h4>The potential benefits of conbercept, aflibercept, and ranibizumab has been reported in patients with wet age-related macular degeneration (wAMD). However, their economic outcomes are still unclear. The current study would assess the cost-effectiveness of conbercept, aflibercept and ranibizumab for patients with wAMD in a Chinese healthcare setting.<h4>Methods</h4>A Markov model was constructed based on patient visual acuity. Five regimens were considered: usual care without a ...[more]

PMID: 32953739

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Project description:BackgroundSeveral studies have investigated the efficacy and safety of Conbercept versus Triamcinolone acetonide for the treatment of wet age-related macular degeneration (wAMD), but the results are controversial. Therefore, this meta-analysis aims to evaluate the efficacy and safety of Conbercept versus Triamcinolone acetonide for the treatment of wAMD.MethodsA total of seven databases were searched for literature on the treatment of wAMD with Conbercept, with the search period from database inception to May 2024. Patients in the experimental group received Conbercept treatment, while patients in the control group received Triamcinolone acetonide treatment. The observed indicators included central macular thickness, incidence of adverse reactions, clinical efficacy, and best-corrected visual acuity. Relative risk (RR) and mean difference (MD) were used as effect measures.ResultsA total of 12 studies with 864 patients were included in the meta-analysis. The results showed that the experimental group had a significantly better central macular thickness (MD = - 42.68, 95% CI = - 55.04 ~ - 30.32, P < 0.001), clinical response rate (RR = 1.25, 95% CI = 1.12 ~ 1.39, P < 0.001), and best-corrected visual acuity (MD = 0.16, 95% CI = 0.12 ~ 0.20, P < 0.001) compared to the control group. In terms of adverse events, the overall incidence of adverse events was lower in the experimental group (RR = 0.26, 95% CI = 0.14 ~ 0.51, P < 0.001) compared to the control group. Specifically, the incidence of intraocular pressure elevation (RR = 0.33, 95% CI = 0.12 ~ 0.94, P = 0.04) and intraocular inflammation (RR = 0.17, 95% CI = 0.03 ~ 0.97, P = 0.05) was lower in the experimental group compared to the control group, but there was no significant difference in the incidence of subconjunctival hemorrhage (RR = 0.7, 95% CI = 0.14 ~ 3.5, P = 0.66) and corneal edema (RR = 0.2, 95% CI = 0.04 ~ 1.12, P = 0.07).ConclusionConbercept demonstrated superior efficacy in treating wAMD compared to triamcinolone acetonide, with a lower incidence of adverse reactions. However, the current meta-analysis included a limited number of studies, with only two studies evaluating best-corrected visual acuity (BCVA). Further high-quality randomized controlled trials (RCTs) are warranted to validate these findings.

Project description:Background: With the advent of aging society of China, fundus diseases related to pathological neovascularization, including age-related macular degeneration (AMD), diabetic macular edema (DME), and pathological myopia (PM), have become an increasingly serious medical and health problems. As effective drugs of the treatment, conbercept and ranibizumab have been commonly used and covered by the national basic medical insurance in China. However, the pharmacoeconomic evaluation of conbercept vs. ranibizumab for DME and PM remains lacking. This study would assess the cost-effectiveness of conbercept and ranibizumab for the treatment of AMD, DME, and PM from the perspective of Chinese payers. Methods: A Markov chain model was constructed based on the visual conditions of the patient indicated by the number of letters in best corrected visual acuity (BCVA). We conducted models based on real-world scenario to calculate the cost per the quality-adjusted life-year (QALY) gained. A 1-year cycle length and a 10-year simulation treatment were applied and the number of injections of conbercept and ranibizumab was assumed to the average number within 10 years. Transition probabilities, costs, utility data, and other parameters were obtained from literature searches. A 3.5% discounting rate was applied for both the costs and utilities. Results: The incremental cost-effectiveness ratios (ICERs) were more favorable for conbercept than ranibizumab in treatment of AMD, DME, and PM, with associated ICER of 66,669 renminbi (RMB), -258,813 RMB, and -373,185 RMB per QALY gained. Compared with ranibizumab, the incremental effectiveness of conbercept in treatment of AMD, DME, and PM was -0.665 QALYs, 0.215 QALYs, and 0.029 QALYs, respectively. The sensitivity analysis showed the same findings, although the ICER is sensitive to the costs of this program. Conclusion: Under the current Chinese healthcare setting, conbercept is suitable and cost-effective in treatment of AMD, DME, and PM compared with ranibizumab.

Dataset Information

Cost-effectiveness of intravitreal conbercept versus other treatments for wet age-related macular degeneration.

Background

Methods

Results

Conclusions

Publications

Cost-effectiveness of intravitreal conbercept versus other treatments for wet age-related macular degeneration.

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