Cost-effectiveness of intravitreal conbercept versus other treatments for wet age-related macular degeneration

Abstract

BACKGROUND: The potential benefits of conbercept, aflibercept, and ranibizumab has been reported in patients with wet age-related macular degeneration (wAMD). However, their economic outcomes are still unclear. The current study would assess the cost-effectiveness of conbercept, aflibercept and ranibizumab for patients with wAMD in a Chinese healthcare setting. METHODS: A Markov model was constructed based on patient visual acuity. Five regimens were considered: usual care without active anti-vascular endothelial growth factor (VEGF) treatment, IVT-AFL (intravitreal aflibercept on a two-monthly basis following three initial monthly doses), RBZ q4 (ranibizumab monthly dosing), RBZ RPN (ranibizumab dose as needed) and IVT-CON (intravitreal conbercept on a three-monthly basis after three initial monthly doses). Clinical, cost, and utility data were collected from published literature. RESULTS: In comparison with usual care, the IVT-AFL, RBZ q4, RBZ PRN, and IVT-CON strategies provided an additional 0.235, 0.338, 0.228, and 0.324 quality-adjusted life years (QALYs), respectively. They had marginal costs of $6,800, $10,084, $4,640, and $6,173, respectively. The strategies also produced incremental cost-effectiveness ratios (ICERs) of $28,892, $29,857, $20,338 and $19,028/QALY, respectively. One-way sensitivity analysis showed utility of blindness (best-corrected visual acuity <35) to have the greatest sensitivity of all the parameters. Probabilistic sensitivity analysis (PSA) indicated that IVT-CON yielded the greatest probabilities of cost-effectiveness (about 92%) compared with other strategies. CONCLUSIONS: Conbercept is a cost-effective option for the treatment of wAMD in a Chinese healthcare setting.