The Cost-Effectiveness of Ranibizumab for the Treatment of XXXX .

@entity1 @entity308 @entity6 @entity1103 @entity1017
PURPOSE: To assess the incremental, comparative effectiveness ( @entity1 @entity1017 ) and cost effectiveness (financial @entity1017 ) associated with 0.3-mg intravitreal ranibizumab injection therapy versus sham therapy for @entity1103 ( @entity1103 ). DESIGN: Value-Based Medicine (Center for Value-Based Medicine, Flourtown, PA) 14-year, cost-utility analysis using @entity1 preferences and 2012 United States real dollars. @entity1 : Published data from the identical Ranibizumab Injection in Subjects with Clinically Significant @entity1103 with Center Involvement Secondary to @entity6 (RISE and RIDE) clinical trials. METHODS: An incremental cost-utility analysis was performed using societal and third-party insurer cost perspectives. Costs and outcomes were discounted with net present value analysis at 3% per annum. MAIN OUTCOME MEASURES: The incremental comparative effectiveness was measured in: (1) quality-adjusted life year (QALY) gain and (2) percent @entity1 value (quality-of-life) gain. Cost effectiveness was quantified with the cost-utility ratio (CUR) measured as  /QALY. RESULTS: The 14-year, incremental @entity1 @entity1017 conferred by intravitreal ranibizumab therapy for @entity6 was 0.9981 QALY, equating to an 11.6% improvement in quality of life. The direct, ophthalmic medical cost for ranibizumab therapy in 1 eye was  30 116, whereas for 2 eyes it was  56 336. The direct, nonophthalmic, medical costs saved from decreased @entity308 , injury, skilled nursing facility admissions, nursing home admissions, and other vision-associated costs totaled  51 758, resulting in an overall direct medical cost of  4578. The net mean societal cost for bilateral ranibizumab therapy was  - 30 807. Of this total, decreased caregiver costs accrued a  31 406 savings against the direct medical costs, whereas decreased wage losses accrued a  3978 savings. The third-party insurer CUR for bilateral ranibizumab therapy was  4587/QALY. The societal cost perspective for bilateral therapy was  - 30 807/QALY, indicating that ranibizumab therapy dominated sham therapy because it conferred both a positive QALY gain of 0.9981 and a financial @entity1017 (positive financial return on investment) of  30 807 referent to the direct ophthalmic medical costs expended. CONCLUSIONS: Intravitreal ranibizumab therapy for the treatment of @entity1103 confers considerable @entity1 ( @entity1 ) @entity1017 . It also accrues financial value to @entity1 , public and private insurers, and society.
