Cost-Effectiveness and Budget Impact Analysis of the Use of Faricimab in Diabetic Macular Edema and Neovascular Age-Related Macular Degeneration in Colombia.

IF 2.3 Q2 ECONOMICS Journal of Health Economics and Outcomes Research Pub Date : 2025-03-04 eCollection Date: 2025-01-01 DOI:10.36469/001c.129832

Daniel Samacá-Samacá, Antonio Robles, Hugo Ocampo, Francisco J Rodríguez, Carolina Sardi-Correa, Laura Prieto-Pinto, Christian Bührer, Camilo Tamayo, David Rodríguez, Mauricio Hernández-Quintana

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Objective: To estimate the cost-effectiveness and budget impact of using faricimab for the treatment of patients with DME and nAMD within the Colombian health system. Methods: This study used a 25-year Markov cohort model to estimate the cost-effectiveness of faricimab vs aflibercept, ranibizumab, and brolucizumab. We used the methodological guidelines of the local health technology assessment agency for conducting the cost-effectiveness and budget impact analysis. Transition probabilities and injection frequencies were derived from the literature. Drug prices were retrieved from public local databases. Quality-adjusted life years (QALYs) were assessed. The potential patient population for the budget impact analysis was estimated based on disease prevalence and expert consultations. Results: Faricimab treat-and-extend (T&E) was dominant vs aflibercept T&E (+0.22 QALYs), ranibizumab T&E (+0.55 QALYs), and brolucizumab for 8 to 12 weeks (+0.06 QALYs) in DME, generating cost savings (in US dollars) of <math><mn>3849</mn> <mo>,</mo></math> 1375, and <math><mn>2824</mn> <mo>,</mo> <mi>r</mi> <mi>e</mi> <mi>s</mi> <mi>p</mi> <mi>e</mi> <mi>c</mi> <mi>t</mi> <mi>i</mi> <mi>v</mi> <mi>e</mi> <mi>l</mi> <mi>y</mi> <mo>.</mo> <mi>I</mi> <mi>n</mi> <mi>n</mi> <mi>A</mi> <mi>M</mi> <mi>D</mi> <mo>,</mo> <mi>f</mi> <mi>a</mi> <mi>r</mi> <mi>i</mi> <mi>c</mi> <mi>i</mi> <mi>m</mi> <mi>a</mi> <mi>b</mi> <mi>a</mi> <mi>l</mi> <mi>s</mi> <mi>o</mi> <mi>s</mi> <mi>h</mi> <mi>o</mi> <mi>w</mi> <mi>e</mi> <mi>d</mi> <mi>d</mi> <mi>o</mi> <mi>m</mi> <mi>i</mi> <mi>n</mi> <mi>a</mi> <mi>n</mi> <mi>c</mi> <mi>e</mi> <mi>v</mi> <mi>s</mi> <mi>a</mi> <mi>f</mi> <mi>l</mi> <mi>i</mi> <mi>b</mi> <mi>e</mi> <mi>r</mi> <mi>c</mi> <mi>e</mi> <mi>p</mi> <mi>t</mi> <mi>a</mi> <mi>s</mi> <mi>n</mi> <mi>e</mi> <mi>e</mi> <mi>d</mi> <mi>e</mi> <mi>d</mi> <mo>(</mo> <mo>+</mo> <mn>0.12</mn> <mi>Q</mi> <mi>A</mi> <mi>L</mi> <mi>Y</mi> <mi>s</mi> <mo>)</mo> <mo>,</mo> <mi>r</mi> <mi>a</mi> <mi>n</mi> <mi>i</mi> <mi>b</mi> <mi>i</mi> <mi>z</mi> <mi>u</mi> <mi>m</mi> <mi>a</mi> <mi>b</mi> <mi>a</mi> <mi>s</mi> <mi>n</mi> <mi>e</mi> <mi>e</mi> <mi>d</mi> <mi>e</mi> <mi>d</mi> <mo>(</mo> <mo>+</mo> <mn>0.05</mn> <mi>Q</mi> <mi>A</mi> <mi>L</mi> <mi>Y</mi> <mi>s</mi> <mo>)</mo> <mo>,</mo> <mi>a</mi> <mi>n</mi> <mi>d</mi> <mi>b</mi> <mi>r</mi> <mi>o</mi> <mi>l</mi> <mi>u</mi> <mi>c</mi> <mi>i</mi> <mi>z</mi> <mi>u</mi> <mi>m</mi> <mi>a</mi> <mi>b</mi> <mn>8</mn> <mi>t</mi> <mi>o</mi> <mn>12</mn> <mi>w</mi> <mi>e</mi> <mi>e</mi> <mi>k</mi> <mi>s</mi> <mo>(</mo> <mo>+</mo> <mn>0.12</mn> <mi>Q</mi> <mi>A</mi> <mi>L</mi> <mi>Y</mi> <mi>s</mi> <mo>)</mo> <mi>w</mi> <mi>i</mi> <mi>t</mi> <mi>h</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>s</mi> <mi>i</mi> <mi>n</mi> <mo>(</mo> <mi>U</mi> <mi>S</mi> <mo>)</mo></math> 7223, <math><mn>5792</mn> <mo>,</mo> <mi>a</mi> <mi>n</mi> <mi>d</mi></math> 6798, respectively. Assuming an annual market share increase for faricimab of 15% for DME and 13% for nAMD, the Colombian Health System could save <math><mn>144</mn> <mi>m</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mi>o</mi> <mi>v</mi> <mi>e</mi> <mi>r</mi> <mn>3</mn> <mi>y</mi> <mi>e</mi> <mi>a</mi> <mi>r</mi> <mi>s</mi> <mo>.</mo> <mi>O</mi> <mi>f</mi> <mi>t</mi> <mi>h</mi> <mi>e</mi> <mi>s</mi> <mi>e</mi> <mi>s</mi> <mi>a</mi> <mi>v</mi> <mi>i</mi> <mi>n</mi> <mi>g</mi> <mi>s</mi> <mo>,</mo></math> 122.7 million are attributed to drug costs and <math><mn>21.3</mn> <mi>m</mi> <mi>i</mi> <mi>l</mi> <mi>l</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mi>t</mi> <mi>o</mi> <mi>a</mi> <mi>d</mi> <mi>m</mi> <mi>i</mi> <mi>n</mi> <mi>i</mi> <mi>s</mi> <mi>t</mi> <mi>r</mi> <mi>a</mi> <mi>t</mi> <mi>i</mi> <mi>o</mi> <mi>n</mi> <mi>c</mi> <mi>o</mi> <mi>s</mi> <mi>t</mi> <mi>s</mi> <mo>(</mo> <mi>U</mi> <mi>S</mi></math> 1 = Col$4325). Conclusion: Considering a willingness to pay threshold of $5988 per additional QALY, faricimab is a cost-effective alternative for both DME and nAMD for the Colombian healthcare system, showing dominance over other anti-vascular endothelial growth factor agents. 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Abstract

Background: Retinal diseases are major contributors to disability, significantly affecting patients' quality of life. Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) represent a significant disease and economic burden in Colombia. Assessing the economic evaluation of available treatments is essential for the efficient allocation of healthcare resources. Objective: To estimate the cost-effectiveness and budget impact of using faricimab for the treatment of patients with DME and nAMD within the Colombian health system. Methods: This study used a 25-year Markov cohort model to estimate the cost-effectiveness of faricimab vs aflibercept, ranibizumab, and brolucizumab. We used the methodological guidelines of the local health technology assessment agency for conducting the cost-effectiveness and budget impact analysis. Transition probabilities and injection frequencies were derived from the literature. Drug prices were retrieved from public local databases. Quality-adjusted life years (QALYs) were assessed. The potential patient population for the budget impact analysis was estimated based on disease prevalence and expert consultations. Results: Faricimab treat-and-extend (T&E) was dominant vs aflibercept T&E (+0.22 QALYs), ranibizumab T&E (+0.55 QALYs), and brolucizumab for 8 to 12 weeks (+0.06 QALYs) in DME, generating cost savings (in US dollars) of $3849,$ 1375, and $2824, r e s p e c t i v e l y . I n n A M D, f a r i c i m a b a l s o s h o w e d d o m i n a n c e v s a f l i b e r c e p t a s n e e d e d (+ 0.12 Q A L Y s), r a n i b i z u m a b a s n e e d e d (+ 0.05 Q A L Y s), a n d b r o l u c i z u m a b 8 t o 12 w e e k s (+ 0.12 Q A L Y s) w i t h s a v i n g s i n (U S)$ 7223, $5792, a n d$ 6798, respectively. Assuming an annual market share increase for faricimab of 15% for DME and 13% for nAMD, the Colombian Health System could save $144 m i l l i o n o v e r 3 y e a r s . O f t h e s e s a v i n g s,$ 122.7 million are attributed to drug costs and $21.3 m i l l i o n t o a d m i n i s t r a t i o n c o s t s (U S$ 1 = Col$4325). Conclusion: Considering a willingness to pay threshold of $5988 per additional QALY, faricimab is a cost-effective alternative for both DME and nAMD for the Colombian healthcare system, showing dominance over other anti-vascular endothelial growth factor agents. Faricimab provides better health outcomes at lower costs vs other treatments.

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法利昔单抗治疗哥伦比亚糖尿病性黄斑水肿和新生血管性年龄相关性黄斑变性的成本-效果和预算影响分析

背景：视网膜疾病是导致残疾的主要原因，严重影响患者的生活质量。糖尿病性黄斑水肿（DME）和新生血管性年龄相关性黄斑变性（nAMD）是哥伦比亚的一个重要疾病和经济负担。评估现有治疗方法的经济评价对于有效分配医疗资源至关重要。目的：评估在哥伦比亚卫生系统内使用法利昔单抗治疗二甲醚和nAMD患者的成本效益和预算影响。方法：本研究采用25年Markov队列模型来评估faricimab与阿非利西贝、雷尼单抗和brolucizumab的成本-效果。我们使用当地卫生技术评估机构的方法指导方针进行成本效益和预算影响分析。过渡概率和注入频率由文献推导。药品价格从当地公共数据库检索。评估质量调整生命年（QALYs）。预算影响分析的潜在患者群体是根据患病率和专家咨询估计的。结果：Faricimab治疗延长（T&E）在DME治疗中占主导地位，而afliberept T&E （+0.22 QALYs）、ranibizumab T&E （+0.55 QALYs）和brolucizumab治疗8 - 12周（+0.06 QALYs），节省成本（以美元计）分别为3849、1375和2824。我n n M D, f r我c I M b l s o s h o w e D D o M I n n c e v s f l I b e r c e p t s n e e D e D (+ 0.12 Q l Y s), r n我b z u M b s n e e D e D (+ 0.05 Q l Y s), n D b r o l u c我z M b 8 t o 12 w e e k s (+ 0.12 Q l Y s) w我t h s v我n g s n(美国)7223,5792,6798 n D,分别。假设二甲醚的市场份额每年增长15%，nAMD的市场份额每年增长13%，那么哥伦比亚卫生系统可以在2011年节省1.44亿美元，而在2010年，哥伦比亚卫生系统可以节省3亿美元。其中，1.227亿美元归因于药品费用，2130万美元归因于医疗费用，其中1亿美元归因于医疗费用，1亿美元归因于医疗费用，1亿美元归因于医疗费用，1亿美元归因于医疗费用。结论：考虑到每个额外的QALY愿意支付5988美元的门槛，faricimab是哥伦比亚医疗保健系统中DME和nAMD的成本效益替代方案，显示出其他抗血管内皮生长因子药物的优势。与其他治疗方法相比，Faricimab以更低的成本提供了更好的健康结果。

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