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Cost effectiveness of photodynamic therapy with verteporfin for age related macular degeneration: the UK case

Smith, D.H., Fenn, P. and Drummond, M. (2004) Cost effectiveness of photodynamic therapy with verteporfin for age related macular degeneration: the UK case. British Journal of Ophthalmology. pp. 1107-1112. ISSN 1468-2079

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Abstract

AIM: To estimate the potential cost effectiveness of photodynamic therapy (PDT) with verteporfin in the UK setting. METHODS: Using data from a variety of sources a Markov model was built to produce estimates of the cost effectiveness (incremental cost per quality adjusted life year (QALY) and incremental cost per vision year gained) of PDT for two cohorts of patients (one with starting visual acuity (VA) of 20/40 and one at 20/100) with predominantly classic choroidal neovascular disease over a 2 year and 5 year time horizon. A government perspective and a treatment cost only perspective were considered. Probabilistic and one way sensitivity analyses were undertaken. RESULTS: From the government perspective, over the 2 year period, the expected incremental cost effectiveness ratios range from £286 000 (starting VA 20/100) to £76 000 (starting VA 20/40) per QALY gained and from £14 000 (20/100) to £34 000 (20/40) per vision year gained. A 5 year perspective yields incremental ratios less than £5000 for vision years gained and from £9000 (20/40) to £30 000 (20/100) for QALYs gained. Without societal or NHS cost offsets included, the 2 year incremental cost per vision year gained ranges from £20 000 (20/100) to £40 000 (20/40), and the 2 year incremental cost per QALY gained ranges from £412 000 (20/100) to £90 000 (20/40). The 5 year time frame shows expected costs of £7000 (20/40) to £10 000 (20/100) per vision year gained and from £38 000 (20/40) to £69 000 (20/100) per QALY gained. CONCLUSION: This evaluation suggests that early treatment (that is, treating eyes at less severe stages of disease) with PDT leads to increased efficiency. When considering only the cost of therapy, treating people at lower levels of visual acuity would probably not be considered cost effective. However, a broad perspective that incorporates other NHS treatment costs and social care costs suggests that over a long period of time, PDT may yield reasonable value for money.

Item Type: Article
Copyright, Publisher and Additional Information: © 2004 BMJ Publishing Group Ltd
Keywords: age related macular degeneration, blindness, cost effectiveness, verteporfin
Academic Units: The University of York > Centre for Health Economics (York)
Depositing User: Repository Officer
Date Deposited: 26 Nov 2004
Last Modified: 17 Oct 2013 14:25
Published Version: http://dx.doi.org/10.1136/bjo.2003.023986
Status: Published
Refereed: Yes
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/208

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