Cost and Health Care Resource Utilization (HCRU) in Patients Starting Intravitreal Dexamethasone (DEX) or ANTI-Vascular Endothelial Growth Factor (AVEGF) in Patients with Diabetic Macular Edema (DME)

Author(s)

Stanford R1, Mercer DW2, Rava A3, Crowley A2, Zhao C4
1AESARA, Chapel HIll, NC, USA, 2Genesis Research, Hoboken, NJ, USA, 3Genesis Research, Madison, NJ, USA, 4AbbVie, Madison, NJ, USA

OBJECTIVES: To understand eye related HCRU and costs over two years in DME patients newly initiating treatment with DEX or aVEGF (ranibizumab-RAN, aflibercept-AFL,bevacizumab-BEV)

METHODS: Retrospective analysis of DME patients using IBM MarketScan database (January 1, 2015 to December 31, 2019). Subjects >18 yo, continuously enrolled >12 months prior and >24 months after treatment initiation, >1 DME diagnosis during pre-index and >1 study treatment at index. Subjects were excluded with >1 pre-index study treatment. DEX and aVEGF were stratified into monotherapy groups as either DEX or branded aVEGF (RAN + AFL) while first combination groups were stratified into either DEX or all aVEGF (RAN + AFL + BEV) groups. Costs and HCRU were assessed over 12 and 24-months using multivariable models controlling for 14 baseline characteristics including total baseline costs.

RESULTS: 2,398 aVEGF (1,914 branded aVEGF mono, 484 all aVEGF-first combo) and 114 (61 mono, 53 first combo) DEX users were included. Controlling for baseline differences, in the monotherapy groups the mean HCRU (95% CI) over 12 months was significantly lower for DEX: 8.05 (6.63 – 9.76), ratio: 0.56 (0.47 – 0.66) compared to branded aVEGF 14.48 (13.17 – 15.94). Mean (95% CI) DME treatment costs were significantly lower for DEX: $2,029 ($1,504 – $2,739) compared to branded aVEGF: $5,727 ($4,891 - $6,707) ratio: 0.35 (0.27 – 0.46).. In the first combination groups DEX was associated with significantly lower HCRU, 13.92 (11.51 - 16.83) and costs $3,108 ($2,276 - $4,244) compared to all aVEGF: HCRU 20.25 (18.21 - 22.51) ratio: 0.69 (0.58 - 0.81) and costs $5,133 ($4,298 - $6,130), ratio: 0.61 (0.30 – 0.81). Trends were similar in year 2.

CONCLUSION: DEX use as initial therapy in DME was associated with significantly lower eye-related HCRU and costs compared to branded aVEGF as monotherapy and all aVEGF first combination in 12 months after initiation of therapy.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Value in Health, Volume 25, Issue 6, S1 (June 2022)

Code

EE385

Topic

Clinical Outcomes, Economic Evaluation, Study Approaches

Topic Subcategory

Comparative Effectiveness or Efficacy, Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

No Additional Disease & Conditions/Specialized Treatment Areas

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