Perspective on anti-VEGF therapy
An analysis conducted by the DRCR.net demonstrates that anti-VEGF therapy for DME with either of the two drugs that have an indication for this use (ranibizumab [Lucentis, Genentech]; aflibercept [Eylea, Regeneron]) is not a cost-effective treatment using a liberal standard of $100,000 per quality-adjusted life-year.
Bevacizumab (Avastin, Genentech) is a less expensive alternative. Its use, however, is accompanied by issues relating to the need for compounding and potential for counterfeiting. It also may be prohibited by regulatory agencies in some countries, Dr. Landers added.
Furthermore, the DRCR.net cost-effectiveness calculations are based on results of its comparative effectiveness in clinical trials. However, research using Medicare data shows that in the real-world, patients are receiving anti-VEGF injections less frequently and achieving less improvement than has been reported in clinical trials.
“In clinical trials, there is a lot more effort devoted to ensure patients attend follow-up visits,” said Dr. Landers. “Compliance in the real world is simply not as good.”