OBJECTIVES: Macular Edema (ME) is the primary complication associated with retinal vein occlusion (RVO), characterized by visual impairment. In Canada, the standard of care is anti-VEGF therapy; which typically involves long-term courses of monthly intravitreal injections. This treatment schedule underscores a significant unmet need for new effective therapies with fewer injections. Clinical evidence supporting faricimab use up to 72 weeks, is based on two Phase III studies (BALATON and COMINO). These studies demonstrated the safety and efficacy of faricimab with extended dosing intervals up to 16 weeks.

METHODS: This analysis informs the cost-effectiveness of faricimab in the treatment of ME secondary to RVO. A Markov model was developed with health states defined based on best corrected visual acuity (BCVA). A Network Meta-Analysis informed comparative treatment effects. Treatment-related costs were determined by whether patients were on or off treatment. Non-treatment related costs were determined via health state occupancy. Utilities were applied by health states, with disutilities for injections. All outcomes and costs were discounted at 1.5%, with a lifetime horizon. All costs were reported as 2024 Canadian dollars.

RESULTS: In the base case, faricimab was the dominant (less costly and more effective) treatment strategy. Over a lifetime horizon, faricimab use resulted in substantially lower costs ($88,831) and better outcomes (11.31 QALYs) than both ranibizumab ($114,690, and 11.11 QALYs) and aflibercept ($97,713, and 11.22 QALYs). Benefits in outcomes were primarily driven by a reduced treatment frequency as well as potential benefits in visual health status. Results were similar from the societal perspective, with further savings attributed to a reduction in costs associated with vision loss.

CONCLUSIONS: Overall, given its significant clinical benefit and reduced injection frequency, faricimab is cost-effective compared to alternative anti-VEGFs for the treatment of ME secondary to RVO.