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Table 7 Sensitivity analysis results for ranibizumab for the treatment of subfoveal neovascular AMD utilizing a societal cost perspective, average cost-utility analysis (bilateral treatment model unless otherwise specified)

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

Interventional variables QALY/QOL gain Cost $/QALY
Eye model    
 2nd eye model, societal costs 1.372/22.8% (−$282,517) (−$205,971)
 2nd eye model, 3rd party insurer costs 1.372/22.8% $24,082 $17,557
 1st eye model, societal costs 0.680/9.8% (−$282,517) (−$415,367)
 1st eye model, 3rd party insurer costs 0.680/9.8% $24,082 $35,406
 Combined-eye model, societal costs—BASE CASE 1.136/16.3% (−$282,517) (−$248,639)
 Combined-eye model, all 3rd party insurer costs 1.136/16.3% $24,082 $21,194
 Combined-eye model, direct ophthalmic medical costs only 1.136/16.3% $79,056 $69,592
Costs    
 Ranibizumab cost increased 100% 1.136/16.3% (−$233,271) (−$205,344)
 Four additional ranibizumab annually, years 3–13 1.136/16.3% (−$213,910) (−$188,301)
 Caregiver costs excluded 1.136/16.3% $15,025 $13,226
 Cost of therapy decreased by 50% 1.136/16.3% (−$322,045) (−$283,490)
Treat-and-extend regimen costs (assuming same value gain) [38]a    
 Direct ophthalmic medical costs only, treat-and- extend, no fellow eye treatment costs 1.136/16.3% $52,250 $45,995
 Current study, direct ophthalmic medical costs, no fellow eye treatment costs 1.136/16.3% $54,569 $48,036
Value gain    
 Patient value gain (QALY gain) drops by 50% for years 5–12, societal costs 0.688/9.9% (−$282,517) (−$410,757)
 Patient value gain (QALY gain) drops by 50% years 5–12, 3rd party insurer costs 0.688/9.9% $24,082 $35,013
Cost-utility    
 For cost-utility of $50,000/QALY 1.136/16.3% $56,800 $50,000
 For cost-utility of $100,000/QALY 1.136/16.3% $113,600 $100,000
  1. Parentheses () negative dollars and negative cost-utility ratios, QALY quality-adjusted life year, QOL quality-of-life, $/QALY cost-utility ratio, or dollars expended per QALY gained. Note that a negative cost-utility ratio simply means that ranibizumab therapy dominates sham therapy in that it confers greater patient value and is less expensive
  2. aRanibizumab injections [38] = year 1—7.6, year 2—5.7, year 3—5.8, year 4—1.8, year 5 forward—none