Budget Impact of Intravitreal Bevacizumab for the Treatment of Age-Related Macular Degeneration in the Argentinian Health System

OBJECTIVES: Age-related macular degeneration (AMD) is a common ocular condition primarily affecting individuals over the age of 50, affecting the macula and impacting central and detailed vision.

Ranibizumab (Lucentis), Aflibercept (Eylia) and off-label Bevacizuman are currently the most used antiangiogenics. The Argentinian Regulatory Agency (ANMAT) approved an exclusive intraocular Bevacizumab (Lumiere).

Assess the economic impact of the introduction of intraocular bevacizumab in the Argentinian Health System.

METHODS: The budget impact model compares a base scenario (16,4% share of Bevacizumab) with two scenarios, considering increased use of bevacizumab from 32% to 57% over a 5-year period time. In one comparative scenario units are used for treatment of single affected eye; in the other, fractioned use was allowed (2 for Aflibercept and 3 for Ranibizumab)

The budget analysis only includes direct healthcare expenses.

Eyes to treat were calculated from 18+ population and prevalence estimated according to local data. All patients were able to receive the mean doses per year.

RESULTS: An estimation of 51,934 eyes with AMD were estimated for year 1, according to prevalence rate and bilateral disease.

The base scenario of 16,4% of intravitreal Bevacizumab had a total expenditure of US$207,379,332 during the first year, US$212,290,420 for 2^nd year, US$ 216,863,493 for 3^rd year, US$ USD 221,303,126 for 4^th year, and US$225,866,613 for the 5^th year.

Savings in comparative scenario 1 (Fractioned use unavailable) are for year 1 US$35,683,823; year 2: US$44,876,754; year 3: US$51,904,506; year 4: US$74,690,973; and year 5: US$90,167,226. Total savings: US$297,323,282.

Savings in comparative scenario 2 (Fractioned use available) are for year 1: US$8,145,806, year 2: US$9,547,827, year 3: US$6,304,632, year 4: US$ 11,999,878; and year 5: US$13,136,888. Total savings: US$49,135,031

CONCLUSIONS: Increase of intravitreal Bevacizumab for managing AMD could contribute to costs saving, ranging from US$49,135,031 to US$297,323,282 over a 5-year period time.