Cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection and panretinal photocoagulation for patients with proliferative diabetic retinopathy in South Korea

BMC Health Serv Res. 2023 Dec 11;23(1):1388. doi: 10.1186/s12913-023-10280-6.

Abstract

Background: We determined the cost-effectiveness of the anti-vascular endothelial growth factor (VEGF) intravitreal injection versus panretinal photocoagulation (PRP) for patients with proliferative diabetic retinopathy (PDR) in South Korea.

Methods: We simulated four treatment strategies using PRP and the anti-VEGF injection by constructing a Markov model for a hypothetical cohort of 50-year-old PDR patients: (1) PRP only; (2) anti-VEGF injection only; (3) PRP first; and (4) anti-VEGF injection first.

Results: In this cost-effectiveness analysis, compared with only-PRP, the incremental cost-effectiveness ratio was $95,456 per quality-adjusted life-year (QALY) for PRP first, $34,375 per QALY for anti-VEGF injection first, and $33,405 per QALY for anti-VEGF injection only from a healthcare perspective. From the societal and payer perspective, strategy (2) was more cost-saving and effective than (1). In the probabilistic sensitivity analysis, only-PRP was cost-effective up to the willingness-to-pay (WTP) of about $42,000, while anti-VEGF injection only was cost-effective from a healthcare perspective. From the societal and payer perspectives, regardless of the value of WTP, anti-VEGF injection only was the most cost-effective strategy.

Conclusion: In our study, the anti-VEGF injection for PDR was cost-effective from the payer and societal perspectives.

Keywords: Anti-VEGF injection; Cost-effectiveness analysis; Panretinal Photocoagulation; Proliferative diabetic retinopathy; South Korea.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Cost-Benefit Analysis
  • Cost-Effectiveness Analysis
  • Diabetes Mellitus* / therapy
  • Diabetic Retinopathy* / drug therapy
  • Diabetic Retinopathy* / surgery
  • Endothelial Growth Factors / therapeutic use
  • Humans
  • Intravitreal Injections
  • Laser Coagulation
  • Middle Aged
  • Ranibizumab / therapeutic use
  • Vascular Endothelial Growth Factor A / therapeutic use

Substances

  • Ranibizumab
  • Angiogenesis Inhibitors
  • Endothelial Growth Factors
  • Vascular Endothelial Growth Factor A