• Luis Javier Hernandez-Pastor, Ana Ortega, Alfredo Garcia-Layana, and Joaquin Giraldez.
• Department of Pharmacy, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain. luisjaher@unav.es
• Clin Ther. 2008 Dec 1; 30 (12): 2436-51.

ObjectiveThis study compared the cost-effectiveness of ranibizumab with that of photodynamic therapy (PDT) in the treatment of predominantly classic choroidal neovascularization secondary to age-related macular degeneration (AMD) from the perspective of a third-party payer in a Spanish setting.MethodsWe constructed a Markov model with 5 states defined by visual acuity (VA) in the better-seeing eye (Snellen scale), as follows: VA >20/40, 20/80, 20/200, 20/400, and ResultsTreating patients with varying degrees of visual impairment with ranibizumab instead of PDT, with a 2-year time horizon, was found to be euro18,328 more costly and to confer 0.140 additional QALY (euro131,275/QALY). This ICER was reduced to euro39,398/ QALY for the longer life-expectancy time horizon. According to the probabilistic sensitivity analysis, PDT is the therapy of choice in all cases below the threshold of euro30,000/QALY for the 2-year time horizon. Ranibizumab was the optimal intervention in 26% of cases in the longer lifetime horizon. When the initial VA was ConclusionsBased on these results, ranibizumab was not cost-effective when administered on a monthly basis. When administered as needed, ranibizumab was cost-effective compared with PDT for the treatment of AMD.

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