OBJECTIVES: Compare the costs of two models of age-related macular degeneration (AMD) treatment in a health insurance company in Brazil.

METHODS: Real-life study evaluating the number of users being treated for AMD, data were extracted from the Unimed Campinas Health Insurance Database. From this database, the number of patients and the respective cost of treatment with anti-VEGF agents were obtained, considering all patients using ranibizumab and aflibercept. For estimation, the adoption of the standard fixed treatment (group 1) and treat and extend (group 2) protocol proposed by the “American Academy of Ophthalmology” (AAO) was considered.

RESULTS: There are currently 922 patients using anti-VEGF therapy for AMD. The average cost of this therapy is approximately US$442.00 per application using the 5-year fixed-treatment model, 40 doses of these drugs will be used, while using the 5-year treat-and-extend model, 23 doses will be used. The costs with group 1 are US$16,300,960.00 and for group 2 are US$9,373,052.00 in five years. This estimate shows an approximate 43% reduction, almost 7 million dollars. Assuming 50% of patients reach the maximum extension interval of 12 weeks as proposed by recent randomized studies, the adoption of the protocol will result in an approximate savings of US$3,463,954.00 in 5 years.

CONCLUSIONS: AMD is a chronic disease with significant costs in all countries, especially for developing countries with limited financial resources. The treat and extend protocol has an important impact reducing the cots allowing for better resource allocation.