[Cost analysis of aflibercept 8 mg versus other anti-VEGF agents]

This study aimed to assess the economic impact of aflibercept 8 mg (114.3 mg/ml, 0.263 ml; hereinafter aflibercept 8 mg) compared with alternative anti-VEGF agents in adult patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) over a 2-year treatment period.

The study compared different anti-VEGF therapies (aflibercept 8 mg; aflibercept 2 mg - 40 mg/ml, 0.278 ml; brolucizumab 6 mg - 120 mg/ml, 0.23 ml; ranibizumab 0.5 mg - 10 mg/ml, 0.23 ml) from the perspective of the healthcare system of the Russian Federation over a 2-year horizon. The number of intravitreal injections was determined based on an indirect comparative analysis; the number of administrations was reconstructed using an anchor value for aflibercept 8 mg and published differences in injection frequencies. Costs were calculated using the weighted average procurement price per package. The burden on the compulsory health insurance (CHI) system was estimated based on the average cost per insurance case (Diagnosis-Related Group, DRG, for "Intravitreal drug administration") of 47 459.63 RUB.

The costs over 2 years were lower with aflibercept 8 mg, resulting in savings of 99 713-140 434 RUB per patient with nAMD and 98 305-173 196 RUB with DME, depending on the comparator drug. When assessing the burden on the CHI system, savings amounted to 142 378-489 783 RUB per patient with nAMD and 119 598-541 039 RUB per patient with DME.

The use of aflibercept 8 mg in nAMD and DME reduces both direct treatment costs and expenditures of the CHI system in the first and second years of therapy, as well as cumulatively over 2 years. The results remain robust under price reductions and support the economic feasibility of the use of aflibercept 8 mg.