biostudies-literatureScotland GHealth Data Research UKBritish Heart FoundationNuffield Department of Population Health, University of OxfordMedical Research CouncilNational Institute for Health Research (NIHR)Chief Scientist OfficeNuffield Department of Population HealthNational Institute for Health and Care Researche70098https://www.ebi.ac.uk/biostudies/studies/S-EPMC7617897biostudies-literatureUnknown42(9)<h4>Aims</h4>The LENS trial demonstrated that fenofibrate slowed the progression of diabetic retinopathy compared to placebo in participants with early diabetic eye disease. We assessed its cost-effectiveness for reducing the progression of diabetic retinopathy versus standard care from a UK National Health Service perspective.<h4>Methods</h4>Resource use and outcome data were collected over follow-up for participants enrolled in LENS. Mean costs were compared at 2 years and per 6-month follow-up (median 4.0 years). Within the trial, cost-effectiveness was assessed in terms of the incremental cost per case of referable disease averted. A microsimulation model, with inputs derived primarily from LENS trial data, was used to assess the incremental cost per quality-adjusted life year (QALY).<h4>Results</h4>Fenofibrate resulted in a mean (95% confidence interval) reduction in health service costs of -£254 (-1062 to 624) at 2 years and -£101 (-243 to 42) per 6-month follow-up. This was accompanied by a 4.4% (1.3% to 8.0%) absolute reduction in any referable diabetic retinopathy or treatment thereof at 2 years, and a 27% (9%-42%) relative reduction over follow-up. Modelled over 10 years, fenofibrate use cost an additional £6 per patient for an expected QALY gain of 0.02, costing £406 per QALY versus standard care under base case assumptions. The probability of cost-effectiveness varied from 70% to 79% at a threshold of £20,000 per QALY, depending on the price discount applied to anti-VEGF drugs.<h4>Conclusions</h4>Fenofibrate is likely to offer a cost-effective treatment for slowing the progression of diabetic retinopathy in people with early to moderate diabetic retinopathy or maculopathy.Diabetic medicine : a journal of the British Diabetic AssociationCost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial.PMC761789714/49/84Young AGardiner KWood SWallendszus KBaxter AVirdi MTaggart DClark CMcAllister CLittle JWhitelaw LDuffy KPatel PTaylor KSammons EMartin LStewart LWincott LDarling JHughes EDuncan MTodd ABurgess FColhoun HCutting CBlackwell SJenkins DCadzow AAitSadi RMeek JMurphy EWillett MBeck DBeesley MBeveridge LPettifor CAdigwe GJWatkins AMcChlery GLyons TYoung IBailey LChamberlain AAchiri PLister LVarikkara MHoward CZettegren PThomson AFinlayson LLocke JFinlayson JMalcolm ESattar NSawyer KZayed MHoward SStyles CTurner LBird KCarty DNeill PWhite AZachariah SPostovalova EPhilip SBagley GWilson AGray KWilson EBlaikie AGoonasekera MLogue JBradley CElliott FGilmour AGill AArmitage JMostefai YFowler SSpata ESpeirs SHallard GHalls HThompson JMcDonald MBrown GSedstrem KBodansky JLENS Collaborative GroupPeddie HKnott CCui GField ARoure IMurray LLeese GNeely DCairns ATsehaye MBurke ACretney RFreeman NDoig JWade RMcGregor AGreig SMciIntyre MCharlwood KBerry CPark SCoventry TMistry MCurrie GRaff RMacliver LJones LStaplin NHurley SBegg AMackenzie IGoodenough BBrogan SOlson JWhitehouse ABarton IMilne LStevens WRyan LJoseph SQuigley JTimadjer AHerlihy OFawcett SMurphy KLiew ASweeney AWilliamson PRaj MBoytha SSharp KEmberson JHarding SDickie SPirie SConnelly PSyed SLindsay JBell ELindsay RDaniels CKurien RLay MPreiss DBell MMadill KWild SBrown MO'Keeffe LScotland GBrown KPickworth SToye JHewick SMurawska AfalseCost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial.<h4>Aims</h4>The LENS trial demonstrated that fenofibrate slowed the progression of diabetic retinopathy compared to placebo in participants with early diabetic eye disease. We assessed its cost-effectiveness for reducing the progression of diabetic retinopathy versus standard care from a UK National Health Service perspective.<h4>Methods</h4>Resource use and outcome data were collected over follow-up for participants enrolled in LENS. Mean costs were compared at 2 years and per 6-month follow-up (median 4.0 years). Within the trial, cost-effectiveness was assessed in terms of the incremental cost per case of referable disease averted. A microsimulation model, with inputs derived primarily from LENS trial data, was used to assess the incremental cost per quality-adjusted life year (QALY).<h4>Results</h4>Fenofibrate resulted in a mean (95% confidence interval) reduction in health service costs of -£254 (-1062 to 624) at 2 years and -£101 (-243 to 42) per 6-month follow-up. This was accompanied by a 4.4% (1.3% to 8.0%) absolute reduction in any referable diabetic retinopathy or treatment thereof at 2 years, and a 27% (9%-42%) relative reduction over follow-up. Modelled over 10 years, fenofibrate use cost an additional £6 per patient for an expected QALY gain of 0.02, costing £406 per QALY versus standard care under base case assumptions. The probability of cost-effectiveness varied from 70% to 79% at a threshold of £20,000 per QALY, depending on the price discount applied to anti-VEGF drugs.<h4>Conclusions</h4>Fenofibrate is likely to offer a cost-effective treatment for slowing the progression of diabetic retinopathy in people with early to moderate diabetic retinopathy or maculopathy.2025-01-01T00:00:00Z2025 Sep2026-04-18T11:15:28.231Z2026-04-07T14:34:19.292ZS-EPMC76178974060772410.1111/dme.70098