Study | Study population | Study design | Outcomes measure(s)/definition | Key finding(s) |
---|---|---|---|---|
Trend of increasing costs | ||||
Campbell et al. [41] | Canada; Ontario Health Insurance Plan | Claims analysis | Total drug costs (anti-VEGF) for Ontario and Canada (2005–2007). | Increase of 8-fold between September 2005 and November 2007 This rapid increase preceded the availability of ranibizumab, strongly suggesting that off-label intravitreal injection of bevacizumab has been highly prevalent |
Coleman et al. [51] (abstract) | US Medicare beneficiaries (5% sample, n = 6290) | Claims analysis | Total eye-related Medicare costs per patient for 5-year study period (1995–1999) based on reimbursed eye-related professional fees; costs of treatment before introduction of PDT and anti-VEGF | Mean (SD): 2371 (2449); median $1607 |
Day et al. [49] | US Medicare beneficiaries | Claims analysis | Distribution of mean Medicare payments for nAMD (1994, 2000, 2006) | Increase of costs largely due to anti-VEGF; dramatic rise between 2004 and 2006 then plateaued Diagnosis more than doubled between 1994 and 2006 |
Kume et al. [48] | Japanese patients with employee health insurance | Claims analysis | Medical expenses per 10,000 patients (2005–2013) | Increase of 9-fold over 9 years, from $1530 to $13,700 Increase of AMD patients by 300% |
Qualls et al. [50] | US Medicare beneficiaries | Claims analysis | Direct medical costs per patient/per case, 1 year before and after the index year (2004–2008) | Costs rose from 2004 to 2006, then plateaued Costs in 2008 cohort were 50% higher than in 2004 Costs attributable to anti-VEGF injections: 4% in 2004; 75% in 2008 cohort |
Rosenfeld et al. [52] | US Medicare and Medicaid | Claims analysis | Total drug costs (anti-VEGF) for Medicare/Medicaid population (2008–2015) | Increase of 2-fold over 8 years, due to an increased number of nAMD patients being treated with anti-VEGF |
Cost savings | ||||
Hanemoto et al. [42] | Patients and their private caregivers from one hospital in Japan | Cross-sectional survey | Mean estimated total annual caregiving costs | 90,327.11 ¥ total annual costs Treatment via T&E rather than PRN reduced number of hospital visits, a reduction in caregiver burden (time, costs, and emotional impact) |
Windsor et al. [43] | US Medicare beneficiaries | Cohort | Medicare reimbursement rate; actual Medicare spending (2008–2015) | $9.0 billion of government savings by using OCT guided anti-VEGF therapy |
Cost estimates reported per country | ||||
Campbell et al. [41] | Canada; Ontario Health Insurance Plan | Claims analysis | Total drug costs (anti-VEGF) for Ontario and Canada (2005–2007) | Projected total cost (of anti-VEGF drugs) in Canada (2007): • Bevacizumab: $2,769,000 • Ranibizumab: $180,000,000 |
Fabiano et al. [44] | Patients from five hospitals in Italy | Clinical database | Mean per-capita costs of treatment and specialist (2016) | 2536 € (treated < 1 year) 1839 € (treated > 1 year) |
Kiss et al. [53] (abstract) | US Patients (data source not reported) | Claims analysis | Mean annual costs per patient (2011–2015) | Treatment = naïve patients • First year with intravitreal aflibercept vs ranibizumab: $10,417 vs $11,032; • First 2 years: $15,410 vs. $15,393 Previously treated patients • First year with intravitreal aflibercept and ranibizumab: $11,521 vs $11,589 • First 2 years: $19,202 vs $18,548 |
Matamoros et al. [45] | French patients who are members of Association DMLA/Retina France | Cross-sectional survey | Mean cost per year per patient/net annual cost for patient (2012–2013) | 1741 € (SD 3397 €, range 0–3176) |
Qualls et al. [50] | US Medicare beneficiaries | Claims analysis | Direct medical costs per patient/per case, 1 year before and after the index year (2004–2008) | Costs rose between 2004 and 2006, then plateaued. Costs in 2008 cohort were 50% higher than in 2004. Costs attributable to anti-VEGF injections: 4% in 2004; 75% in 2008 cohort |
Rosenfeld et al. [52] | US Medicare and Medicaid | Claims analysis | Total drug costs (anti-VEGF) for Medicare/Medicaid population (2008–2015) | Total annual drug costs in 2008: • Intravitreal aflibercept: not applicable • Bevacizumab: $35,502,851 (583,351 doses) • Ranibizumab: $704,066,862 (327,663 doses) Total annual drug costs in 2015: • Intravitreal Aflibercept: $1,738,642,274 (836,425 doses) • Bevacizumab: $89,488,151 (1,225,348 doses) • Ranibizumab: $1,133,896,626 (542,820 doses) |
Schmidt et al. [47] | Patients of largest public ophthalmologic clinic in Switzerland | Claims analysis | Total healthcare costs per patient/per month, directly attributed to anti-VEGF therapy (2006–2014) | 2186.98 CHF (95% CI: 1184.58 to 3189.38) In the subgroup of patients with AMD, the costs for ophthalmologic treatment sank by 97.23 CHF/year (95% CI, 985.38–790.92; P = 0.829) |
Shalaby et al. [46] | Patients from UK NHS ophthalmological units (189 requests; 95.8% responses) | Cross-sectional request | Estimated annual costs of anti-VEGF drugs (incl. VAT) (2015) | Total: £539,764,992 Bevacizumab only: £729,500 |