From: A Value-Based Medicine cost-utility analysis of genetic testing for neovascular macular degeneration
Mean vision at 12, 24, and LOCF to 144 months | Utility at 12, 24, and LOCF to 144 months | 12-year QALY accrual | Per early-treatment patient QALY gain (QOL gain) integrating conversion of 2nd eyes to NVAMD without adjustments | Per early-treatment patient QALY gain (QOL gain) (adjusting for 1st eye and 2nd eye, 78.0 % × 62.2 %, with 90 % gene testing sensitivity) | |
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12 months Sham 24 months 96 months (baseline vision = 20/40–20/80) | 20/126 20/160−2 20/640 | 0.682 0.657 0.538 | 5.990 | 0.0 (0.0 %) | 0.0 (0.0 %) |
Early ranibizumab treatment (mean baseline vision = 20/40–20/80) | 20/40−1 | 0.789 | 7.924 | 1.933 (32.8 %) | 0.845 (14.1 %) |
Late ranibizumab treatment (mean baseline vision = ≤20/160) | 20/160+2 | 0.658 | 6.561 | 0.571 (9.5 %) | 0.250 (4.2 %) |
Incremental gain, early vs. late ranibizumab treatment patient made possible by genetic testing | NA | 0.141 | 1.363 | 1.363 (23.3Â %) | 0.595 (10.0Â %) |
Cohort | NA | NA | 12-year QALY accrual | Per screened patient QALY gain (QOL gain) integrating 2nd eye conversion to NVAMD | Per screened patient QALY gain (QOL gain) (adjusting for 1st eye and 2nd eye, 78.0 % × 62.2 %, with 90 % gene testing sensitivity) |
---|---|---|---|---|---|
Incremental gain, per patient genetic screened/monitored for NVAMD | NA | NA | 0.0432 | 0.0432 (0.71Â %) | 0.0185 (0.33Â %) |