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Analysis: Lucentis may be more cost-effective than Eylea for DME

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VIENNA — A cost-effectiveness analysis based on Protocol T results found considerably higher costs and minimal gain in quality-adjusted life-years with Eylea compared with Lucentis for the treatment of diabetic macular edema, leading to the conclusion that Lucentis may be more cost-effective.

“We used the Markov model, which takes visual acuity and divides it into groups from best to worst vision, and then we used an algorithm to sort these visual acuities into visual impairment costs and QALYs,” Nancy Holekamp, MD, said at the American Society of Retina Specialists meeting.

Nancy Holekamp

Results were divided according to baseline visual acuity of 20/40 or better and 20/50 or worse.

For patients with baseline vision of 20/40 or better, a reported $8,000 difference was found for the 1-year treatment in Protocol T between Lucentis (ranibizumab, Genentech) and Eylea (aflibercept, Regeneron). No difference in QALY was found.

For patients with visual acuity of 20/50 or worse, the analyzed costs for treatment were also $8,000 less with ranibizumab, and a minimal difference in QALY of 0.0103 was found in favor of aflibercept.

“This study has limitations because the QALY endpoint may be subjective and only 1 year of follow-up is available, based on U.S. practices only,” Holekamp said.

She noted, however, that results were consistent with the conclusions of a U.K. Markov analysis based on the RESTORE, VIVID and VISTA studies, which showed that from a U.K. health care perspective, ranibizumab provides greater health gains with lower overall costs for patients with visual impairment due to DME.

“Given the minimal difference in QALYs and the difference in cost of this study, ranibizumab may be more cost-effective than aflibercept for DME,” Holekamp said. – by Michela Cimberle

Disclosure: Holekamp reports she is a consultant for Alcon and Genentech and is on the Novartis speakers bureau.