Ranibizumab (Lucentis) versus bevacizumab (Avastin): modelling cost effectiveness

Area of Science:

• Ophthalmology
• Health Economics

Background:

• Age-related macular degeneration (AMD) is a leading cause of vision loss.
• Ranibizumab (Lucentis) and bevacizumab (Avastin) are used to treat AMD.
• Significant cost disparities exist between these two treatments.

Purpose of the Study:

• To compare the clinical and cost-effectiveness of ranibizumab versus bevacizumab for AMD treatment.
• To assess the cost per quality adjusted life year (QALY) over a 10-year period.

Main Methods:

• Development of a cost-effectiveness model.
• Analysis of predominantly classic AMD, minimally occult AMD, and occult with no classic lesions.

Main Results:

• Bevacizumab is significantly more cost-effective than ranibizumab for all forms of AMD studied.
• Ranibizumab would require a substantial price reduction to approach the NICE cost-effectiveness threshold of 30,000 pounds per QALY.
• The relative efficacy of bevacizumab would need to be approximately 40% of ranibizumab's for ranibizumab to be cost-effective.

Conclusions:

• Bevacizumab represents a highly cost-effective treatment option for AMD.
• The current pricing of ranibizumab makes it less cost-effective for AMD treatment.
• The unlicensed use of bevacizumab raises ethical, legal, and policy considerations, with public pressure suggested as a means to encourage licensing.