Cost-Utility Analysis of Faricimab Versus Aflibercept in Treating Neovascular Age-Related Macular Degeneration (nAMD) in the United States.

IF 2.4 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2026-05-01 Epub Date: 2026-03-06 DOI:10.1007/s41669-026-00643-0

Ahmead Baljoon, Vakaramoko Diaby, Sandra Suther, Matthew Dutton, Askal Ali, Islam Eljilany

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引用次数: 0

Abstract

Background/objective: Neovascular age-related macular degeneration (nAMD) imposes a substantial clinical and economic burden in the United States (US). Faricimab offers the potential for longer dosing intervals than aflibercept, but its economic value in the US setting has not been established. This study evaluated the cost utility of faricimab versus aflibercept for treating nAMD from the US payer perspective.

Methods: A Markov model of five health states defined by best-corrected visual acuity (BCVA) simulated disease progression over 5 years. Clinical inputs were drawn from pooled 1-year data of the TENAYA and LUCERNE phase III trials (n = 1329), which compared faricimab with aflibercept for treating nAMD patients. Direct medical costs encompassed drug acquisition, intravitreal administration, monitoring, office visits, and management of endophthalmitis. Outcomes included total costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), and net monetary benefit (NMB) at a willingness-to-pay (WTP) threshold of US$100,000/QALY. Scenario, deterministic, and probabilistic sensitivity analyses (10,000 iterations) were conducted.

Results: In the base case, faricimab yielded 2.80 QALYs for US$52,797, whereas aflibercept produced 2.72 QALYs at US$62,367. Faricimab was therefore dominant (- US$9570; + 0.08 QALY), with an incremental NMB of US$17,981. Faricimab required markedly fewer injections over 5 years (22.6 vs 34). Scenario analyses did not materially change the directionality of the base-case results, with faricimab being dominant or cost effective. The model was most sensitive to drug acquisition prices and BCVA-state utilities, yet faricimab remained below the WTP threshold across all plausible ranges. Probabilistic analysis showed a 97% probability of faricimab being cost effective at US$100,000/QALY.

Conclusions: Faricimab is estimated to be a cost-effective treatment option compared with aflibercept for nAMD from a US payer perspective. This finding may support its inclusion in treatment guidelines and formulary decisions, pending confirmation in real-world practice.

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法利昔单抗与阿非利塞普在美国治疗新生血管性年龄相关性黄斑变性（nAMD）的成本-效用分析

背景/目的：新生血管性年龄相关性黄斑变性（nAMD）在美国造成了巨大的临床和经济负担。Faricimab比aflibercept具有更长的给药间隔的潜力，但其在美国的经济价值尚未确定。本研究从美国付款人的角度评估了法利昔单抗与阿非利西普治疗nAMD的成本效用。方法：用最佳矫正视力（BCVA）定义的五种健康状态的马尔可夫模型模拟疾病在5年内的进展。临床输入来自TENAYA和LUCERNE III期试验的1年汇总数据（n = 1329），比较了faricimab和afliberept治疗nAMD患者的疗效。直接医疗费用包括药物购买、玻璃体内给药、监测、办公室就诊和眼内炎的治疗。结果包括总成本、质量调整生命年（QALYs）、增量成本效益比（ICER）和支付意愿（WTP）阈值为100,000美元/QALY时的净货币效益（NMB）。进行了场景、确定性和概率敏感性分析（10,000次迭代）。结果：在基本情况下，faricimab产生2.80个QALYs，价格为52,797美元，而afliberept产生2.72个QALYs，价格为62,367美元。因此，Faricimab占主导地位（- 9570美元；+ 0.08 QALY）， NMB增量为17,981美元。Faricimab在5年内需要的注射次数明显减少（22.6 vs 34）。方案分析没有实质性地改变基本病例结果的方向性，法利昔单抗占主导地位或具有成本效益。该模型对药品收购价格和bcva国家公用事业最敏感，但faricimab在所有合理范围内仍低于WTP阈值。概率分析显示，faricimab在10万美元/QALY时具有成本效益的概率为97%。结论：从美国付款人的角度来看，与阿非利西普相比，Faricimab估计是一种具有成本效益的nAMD治疗选择。这一发现可能支持将其纳入治疗指南和处方决定，有待在实际实践中确认。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.