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Table 5 Societal and 3rd party insurer cost perspective cost-utility analyses (2015 U.S. real dollars discounted at 3% annually)

From: The comparative effectiveness and cost-effectiveness of ranibizumab for neovascular macular degeneration revisited

Cost perspective Societal 3rd party insurer
Ranibizumab therapy, direct ocular medical costsa 79,056 79,056
Depressionb (2543) (2543)
Injuryb (664) (664)
Subacute Nursing Facility (SNF)b (4100) (4100)
Nursing homeb (19,046) (19,046)
Unexplained direct medical Medicare costsb (28,598) (28,598)
Patient employment gaina (9057)
Paid caregivers released from jobsb (82,419)
Increased paid employment by freed-up unpaid caregiversa (215,123)
Total costs offsetting the direct ophthalmic medical costs (361,573) (54,974)
Direct medical costs + offsetting costs = financial return to society 282,517 (24,082)
Financial ROI for direct ophthalmic medical costs expended 14.7% −3.5%
QALY gain: combined-eye model 1.136 1.136
QALY gain: second-eye model 1.372 1.372
VRQOL gain, combined-eye model 16.3% 16.3%
VRQOL gain, second-eye model 22.8% 22.8%
$/QALY, combined-eye model (242,921) 20,707
$/QALY, second-eye model (205,916) 17,552
Addition to GDP 165,842 24,082
Financial ROI for GDP referent to direct ophthalmic medical costs expended 7.0% −11.4%
  1. Costs in parentheses () are negative costs, indicating they are accrued against the direct ophthalmic medical costs of ranibizumab therapy
  2. MARINA minimally classic/occult trial of the anti-VEGF antibody ranibizumab in the treatment of neovascular age-related macular degeneration (AMD) [9], VRQOL vision-related quality-of-life, 3rd party insurer third party insurer cost perspective utilizing the direct ocular medical costs and the direct non-ophthalmic medical costs
  3. ROI return-on-investment, QALY quality-adjusted life-year, $/QALY dollars expended per QALY gained, gained, VRQOL vision-related quality-of-life
  4. aCosts adding to the Gross Domestic Product (GDP)
  5. b Costs subtracting from the Gross Domestic Product