Table 1 MARINA study clinical and cost-utility analysis parameters
Clinical features [1] | |
 Each participant had minimally classic or occult, subfoveal choroidal neovascularization | |
 Best corrected ETDRS entrance vision in the affected eye: 20/40–20/320 | |
 Choroidal neovascular lesions <12 disc areas at baseline | |
 Baseline vision: mean 20/80 − 1 in both the ranibizumab treatment and sham treatment cohorts | |
 Mean baseline age: 77 years | |
 Treatment protocol: Participants were randomized equally to: (1) a 0.5 mg intravitreal ranibizumab dose cohort (n = 240), (2) a 0.3 mg intravitreal ranibizumab dose cohort (n = 238) or (3) a sham injection treatment cohort (n = 238) | |
 Only data from the 0.5 mg ranibizumab cohort (0.5 mg was the dose eventually approved by the Food & Drug Administration [5]) and the sham treatment control cohort were utilized in the cost-utility analysis herein | |
 The average participant received 22 × 0.05 cc intravitreal injections, given approximately monthly, over 2 years | |
Cost-utility analysis assumptions | |
 Mean life expectancy: 12 years for the control and ranibizumab study cohorts [9] | |
 12-year time span for model utilizing 2-year MARINA data from the sham treatment control group and the 0.05 mg ranibizumab treatment group | |
 Societal and 3rd party insurer cost perspectives | |
 Cost basis: average 2015, national, Medicare Fee Schedule | |
 Vision utilities (based upon visual acuity in the better-seeing eye) [24,25,26,27,28,29,30,31] | |
 Vision | Utility |
  20/20 OU | 0.97 |
  20/40 | 0.80 |
  20/80 | 0.701 |
  20/200 | 0.62 |
  20/640 | 0.538 |
 Sham treatment, control cohort data utilized: mean vision in MARINA Study for years 1 and 2; Lineweaver-Burke plot meta-analysis [20] control cohort for years 3–12 | |
 Treatment cohort (0.5 mg ranibizumab) mean vision: MARINA Study for years 1 and 2, HORIZON open-label extension trial for 25–49 months, LOCF (last observation carried forward) for months 49–144 [23] | |
 Net Present Value (NPV) analysis discounts value outcomes and costs at a 3% annual rate, as per the Panel on Cost-Effectiveness in Health and Medicine [13, 18] | |
 Adverse events as previously listed [9] | |
 Patient utilities as previously listed [9] | |