Skip to main content

Table 9 Societal, cost-utility ratios for category 3 [5] age-related macular degeneration (AMD) patients undergoing genetic testing to predict progression to neovascular AMD

From: A Value-Based Medicine cost-utility analysis of genetic testing for neovascular macular degeneration

Incremental % of patients undergoing early-treatment ranibizumab therapy due to genetic testing (# of patients)

Genetic testing/moni-toring medical costsa (000s)

Negative costsa (000 s)

Total costs (direct medical + negative costs (000s)

Overall cost (direct medical + negative costs) per patient tested

QALY gain per patient screened

$/QALY

1 % (1618)

$2,082,402

(−$367,918)

$1,714,484

$1815

0.0010

$1,781,400

2 % (3235)

$2,082,402

(−$735,835)

$1,346,567

$1426

0.0020

$699,562

3 % (4853)

$2,082,402

(−$1,103,752)

$978,649

$1036

0.0031

$338,949

4 % (6470)

$2,082,402

(−$1,471,670)

$610,732

$647

0.0041

$158,642

4.1 % (6634)

$2,082,402

(−$1,508,464)

$573,938

$605

0.0042

$144,000

4.5 % (7119)

$2,082,402

(−$1,607,802)

$474,600

$450

0.0045

$100,000

5 % (8088)

$2,082,402

(−$1,839,588)

$242,814

$257

0.0051

$50,458

10 % (16,175)

$2,082,402

(−$3,679,175)

(−$1,596,774)

(−$1691)

0.0102

(−$165,910)

15 % (24,263)

$2,082,402

(−$5,518,763)

(−$3,436,361)

(−$3639)

0.0153

(−$238,032)

20 % (32,351)

$2,082,402

(−$7,358,351)

(−$5,275,949)

(−$5587)

0.0204

(−$274,093)

30 % (48,526)

$2,082,402

(−$11,037,527)

(−$8,955,125)

(−$9482)

0.0306

(−$310,155)

34.6 % (56,048)

$2,082,402

(−$12,738,343)

(−$10,665,141)

(−$11,294)

0.0353

(−$319,834)

38.5 % (62,275)

$2,082,402

(−$14,164,826)

(−$12,082,424)

(−$12,794)

0.0392

(−$326,078)

  1. The societal costs perspective included the following costs: (a) direct ophthalmic medical costs, (b) direct non-ophthalmic medical costs (depression, trauma, skilled nursing facility, nursing home, other Medicare costs) + caregiver costs + employment costs saved by genetic testing leading to early-treatment, versus late-treatment, of neovascular age-related macular degeneration with intravitreal ranibizumab
  2. Direct non-ophthalmic medical costs = costs for depression, trauma, skilled nursing facilities, nursing homes and other Medicare costs
  3. The model is a combined-eye model integrating the patient value gain and costs associated with first-eye (78.0 % presenting with vision <20/160) and second-eye (62.2 % of eyes presenting with 20/20/160 vision) ranibizumab therapy for neovascular AMD, assuming genetic testing identifies 90 % of cases that will progress to neovascular age-related macular degeneration
  4. A negative cost-utility ratio () indicates that early-treatment dominates late treatment, meaning that early-treatment accrues greater QALYs and has a positive financial return-on-investment
  5. QALY quality-adjusted life-year, $/QALY cost-utility ratio, or dollars expended/gained per QALY gained from genetic testing
  6. aDirect ophthalmic medical costs = costs associated with genetic screening, including $1906 for screening and $299 for 1 extra annual examination and optical coherence tomography scan for the 22.5 % of Category 3 AMD patients with a high risk genetic profile for progression to neovascular age-related macular degeneration
Back to article page

International Journal of Retina and Vitreous

ISSN: 2056-9920

Contact us