000125343 001__ 125343
000125343 005__ 20240319081005.0
000125343 0247_ $$2doi$$a10.1186/s12962-022-00401-z
000125343 0248_ $$2sideral$$a133074
000125343 037__ $$aART-2022-133074
000125343 041__ $$aeng
000125343 100__ $$0(orcid)0000-0001-7962-6417$$aMontes Rodríguez, Paula
000125343 245__ $$aCost-effectiveness of dexamethasone compared with aflibercept in naïve diabetic macular edema
000125343 260__ $$c2022
000125343 5060_ $$aAccess copy available to the general public$$fUnrestricted
000125343 5203_ $$aAbstract
Background
To assess the cost-effectiveness of the delayed-release device of dexamethasone compared with aflibercept in the treatment of patients with naïve diabetic macular edema (DME) from a societal perspective in the healthcare sector Zaragoza III in Spain.
Methods
A Markov model with five states defined by visual acuity (VA) in the better-seeing eye (Snellen scale) and an additional death state were constructed. Two cohorts of patients were distributed along the VA states and treated during a year with either dexamethasone or aflibercept. One-year follow-up on each group was performed. Medical costs related to the DME treatment and follow-up, medical costs related to the DME comorbidities, and non-medical-related costs were taken into account. Costs (2020 €), health outcomes (Quality-Adjusted Life Years-QALYs), both discounted at a 3.5% annual rate, and incremental cost-effectiveness ratios (ICER: €/QALY) were determined for a lifetime horizon in the base case analysis.
Results
Patients treated with dexamethasone were €77,349 more costly and provided 2.667 additional QALYs (€29,002/QALY) than those treated with aflibercept. The variable efficiency per patient was calculated dividing the improvement in quality of life (on the VFQ-25 scale) by the cost of the treatment. With the obtained results it can be concluded that the efficiency of treating the patients with dexamethasone is significantly superior than the efficiency of treating them with aflibercept.
Conclusions
The cost per QALY gained with the delayed-release device of dexamethasone compared with the one obtained by aflibercept in the naïve DME population is just below the €30,000 threshold, below which, new drugs are sometimes regarded as cost-effective strategies in Spain. In this model, the key variables with greater impact on the cost-effectiveness results were the selected time horizon, the chosen extrapolation method and the number of aflibercept and dexamethasone injections.
000125343 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000125343 590__ $$a2.3$$b2022
000125343 592__ $$a0.53$$b2022
000125343 591__ $$aHEALTH POLICY & SERVICES$$b59 / 87 = 0.678$$c2022$$dQ3$$eT3
000125343 593__ $$aHealth Policy$$c2022$$dQ2
000125343 594__ $$a2.9$$b2022
000125343 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000125343 700__ $$aMateo Gabás, Javier$$uUniversidad de Zaragoza
000125343 700__ $$aEsteban Floría, Olivia$$uUniversidad de Zaragoza
000125343 700__ $$aHonrubia Grijalbo, Ana
000125343 700__ $$0(orcid)0000-0001-9876-5850$$aAscaso Puyuelo, Francisco J.$$uUniversidad de Zaragoza
000125343 7102_ $$11013$$2646$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Oftalmología
000125343 773__ $$g20, 1 (2022), 10$$pCost eff. resour. alloc.$$tCost Effectiveness and Resource Allocation$$x1478-7547
000125343 8564_ $$s1041486$$uhttps://zaguan.unizar.es/record/125343/files/texto_completo.pdf$$yVersión publicada
000125343 8564_ $$s2327711$$uhttps://zaguan.unizar.es/record/125343/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000125343 909CO $$ooai:zaguan.unizar.es:125343$$particulos$$pdriver
000125343 951__ $$a2024-03-18-14:30:42
000125343 980__ $$aARTICLE