September 12, 2017
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AREDS supplement found cost-effective in wet AMD

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A study based on a patient level simulation model demonstrated that the use of Age-Related Eye Disease Study supplements in patients with AREDS category 4 neovascular age-related macular degeneration in one eye would be highly cost effective in the U.K. National Health Service setting, leading to significant saving from decreased need of ranibizumab injections.

The simulation model involved patients with either bilateral intermediate AMD, AREDS category 3, or unilateral neovascular AMD, AREDS category 4, and equivalent untreated groups. It was based on a large body of data from clinical trials, real-world outcome studies and a national database containing 92,976 ranibizumab treatment episodes.

Resource use and cost reflected current U.K. clinical practice, involving a loading dose of three monthly ranibizumab injections followed by regular visits and as-needed retreatment. AREDS 1 or 2 formulations or AREDS2 for current or former smokers were used.

The use of AREDS supplements in category 4 patients turned out to be a cost-effective strategy, leading to a mean of 7.67 fewer anti-VEGF injections and related cost and a gain of 0.16 QUALYs as compared with no use of supplements. In category 3 patients, despite a mean of 3.07 fewer anti-VEGF injections in the treated group, the overall cost of using supplements resulted in an incremental cost-effectiveness ratio of 30,197.

“In conclusion, this model demonstrates that the use of AREDS supplements is a dominant cost-effective intervention for use for AREDS category 4 patients with neovascular AMD in one eye in the U.K.,” the authors noted, while publicly funding AREDS supplements for category 3 “would depend on the health care system willingness to pay.” – by Michela Cimberle

Disclosure: Lee reports no financial disclosures. Please see the study for the other author’s financial disclosures.