Cost-effectiveness analysis of individualized versus standardized anti-VEGF therapy in AMD patients

Roer, Maria Klit Muldbak

4. term

Medicine with Industrial Specialisation, Master

2013

2013-05-30

18 pages

Introduction: Age-related Macular Degeneration (AMD) is the leading cause of vision loss among people at 60 years or above in the developed countries3. The recommended treatment has, until now, been a standardized therapy procedure. But new evidence suggests that the patients will have more benefit from an individualized therapy. Objective: To compare cost and health consequences in AMD patients receiving anti-VEGF treatment in standardized therapy of three injections or individualized therapy of injection only by indication, by combining statistical process control (SPC) and cost-effectiveness analysis (CEA) Method: SPC is used to evaluate the process for a given period of time. On the basis of the SPC, a CEA was performed by use of a decision analytic model to compare the standardized therapy with individualized therapy. The model begins when the patients receive the first injection or control visit and the effect measure is infections averted. A probabilistic sensitivity analysis (PSA) was made to evaluate the result. Results: The SPC illustrate that there was a drop in number of injections after the individualized therapy was implemented. The CEA showed a cost saving on 5% and a probability on 0.133% of infections averted. Conclusion: This analysis implies that the individualized therapy is the preferred strategy because it is both cost-reducing and quality-increasing. But because of the unstable SPC process further evaluation is recommended.

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