From: A Value-Based Medicine cost-utility analysis of genetic testing for neovascular macular degeneration
Cost perspec- tive | Incremental % of patients undergoing early-treatment ranibizumab therapy due to genetic testing (# of patients) | Genetic testing/monitoring medical costsa (000s) | Negative costs (000s) | Total costs (direct medical + negative costs (000s) | Overall cost (direct medical + negative costs per patient tested | QALY gain per patient | $/QALY |
---|---|---|---|---|---|---|---|
$500 cost for genetic testing, screening at age 65 | |||||||
 Societal | 4.1 % (6,634) | $754,576 | (−$1,508,464) | (−$839,978) | (−$890) | 0.0043 | (−$321,506) |
 3rd party | 10.1 % (16,504) | $754,576 | (−$675,036) | (−$79,540) | (−$84) | 0.0103 | (−$26,389) |
$1000 cost for genetic testing, screening at age 65 | |||||||
 Societal | 4.1 % (6634) | $1,226,776 | (−$1,508,464) | (−$281,688) | (−$298) | 0.0042 | (−$71,047) |
 3rd party | 10.1 % (16,504) | $1,226,776 | (−$675,036) | $551,740 | $584 | 0.0103 | $56,744 |
Patient value unchanged, change age of screening from 65 to 60Â years | |||||||
 Societal | 4.1 % (6634) | $2,817,145 | (−$1,508,464) | $1,312,591 | $1390 | 0.0042 | $330,075 |
 3rd party | 10.1 % (16,504) | $2,817,145 | (−$675,036) | $2,142,109 | $2,269 | 0.0103 | $220,291 |
Patient value unchanged, change age of screening from 65 to 52Â years | |||||||
 Societal | 4.1 % (6634) | $3,787,988 | (−$1,508,464) | $2,279,524 | $2415 | 0.0042 | $574,940 |
 3rd party | 10.1 % (16,504) | $3,787,988 | (−$675,036) | $3,112,952 | $3,298 | 0.0103 | $320,167 |
Patient value unchanged, change age of screening from 65 to 40Â year | |||||||
 Societal | 4.1 % (6634) | $5,823,170 | (−$1,508,464) | $4.314,706 | $4571 | 0.0042 | $1,088,253 |
 3rd party | 10.1 % (16,504) | $5,823,170 | (−$675,036) | $5,148,134 | $5454 | 0.0103 | $529,469 |
No extra eye exams and OCT in addition to two annual visits, screening at age 65 | |||||||
 Societal | 4.1 % (6634) | $1,800,026 | (−$1,508,464) | $291,562 | $309 | 0.0042 | $73,538 |
 3rd party | 10.1 % (16,504) | $1,800,026 | (−$675,036) | $1,124,990 | $1192 | 0.0103 | $115,702 |
Four extra eye exams and OCT’s in addition to two annual visits, screening at age 65 | |||||||
 Societal | 4.1 % (6634) | $3,211,904 | (−$1,508,464) | $1,703,440 | $1804 | 0.0042 | $429,641 |
 3rd party | 10.1 % (16,504) | $3,211,904 | (−$675,036) | $2,536,868 | $2687 | 0.0103 | $250,909 |
Early-treatment ranibizumab cases receive twice as many injections over the first 2Â years of therapy than late treatment casers, screening at age 65 | |||||||
 Societal | 4.1 % (6634) | $2,667,392 | (−$1,508,464) | $1,072,038 | $1136 | 0.0042 | $270,591 |
 3rd party | 10.1 % (16,504) | $2,667,392 | (−$675,036) | $1,992,356 | $2111 | 0.0103 | $204,907 |