Cost-effectiveness of treatment schemes in wet age-related macular degeneration in Colombia

Introduction: Comparison of costs in intravitreal treatment regimen for Wet Age-Related Macular Degeneration (Wet-AMD) in fixed-treat and extend regimens for Ranibizumab and Aflibercept. Objective: Cost-effectiveness analysis according to the frequencies used and recommended without loss of vision obtained in two years of treatment. Methods: Cost effectiveness analysis in administrative reports (SISMED base of Colombia) third quarter of 2020-2021; Sensitivity analysis with the new presentation of Aflibercept pre-filled syringe versus the pre-filled presentation of Ranibizumab. Values data correspond to billable dispensing units; the effectiveness is the frequency of application of the drugs in which the scientific literature certifies the non-loss of the gain of letters acquired by the patients. Results: The fixed dose model Aflibercept therapy for Wet-AMD presents a greater gain than Ranibizumab in comparative effectiveness of 18.0%, influenced by the frequency, the percentage of cost variation 22.1% in favor of Aflibercept. The cost-effectiveness model to treat-extend shows a gain in comparative effectiveness of 40.4% and the variation in cost of 11.2% for Aflibercept. The sensitivity model in two years of treatment shows; fixed-dose regimen Ranbizumab U$ 8 965.1 and Aflibercept U$ 5,661.3. In the treat-extend model, in the same period, it reports Ranibizumab U$ 6 884.4 and Aflibercept U$ 5 035.6. Conclusion: Both Ranibizumab and Aflibercept are indicated for the treatment of Wet-AMD, with reported vision gain, the frequency in the fixed dose scheme and treat-extend are lower in Aflibercept. Greater cost effectiveness was evidenced in Aflibercept, influenced by the number of applications in the two comparative models. The sensitivity study for the new presentation of Aflibercept generates lower costs in two years of treatment, however, more data is required in administrative bases to infer the cost containment in the treatment compared to Ranibizumab.