[Cost-effectiveness of photodynamic therapy with verteporfin for choroidal neovascularization in age-related macular degeneration in routine clinical practice in Switzerland].
OBJECTIVE
Age-related macular degeneration is the leading cause of legal blindness in older people. Choroidal neovascularization (CNV) is treatable with photodynamic therapy with verteporfin (PDT) but is expensive. The aim of this study was to assess the cost-effectiveness of PDT in routine clinical practice in Switzerland.


METHODS
A Markov model was used to analyze the costs of PDT in routine clinical practice. It described patients moving between good or impaired vision (visual acuity [VA]>0.1) and highly impaired vision (VA<0.1). Costs for PDT were based on the results of the Donati open-labeled prospective clinical study. Costs for medical and social management of AMD patients were defined according to Grainer's study.


RESULTS
The cost of PDT varied from 8,800 to 10,969 euros/patient/year. Ninety percent of the patients retained a VA > or =0.1. Health costs saved by keeping patients from moving to the highly impaired vision group was 4,248 euros/patient/year. Incremental costs per vision-year saved varied from 8,239 to 10,271 euros. Cost per quality-adjusted life year (QALY) gained at 5 years was 65,150 euros.


CONCLUSIONS
PDT was found to be moderately cost-effective in Switzerland. The longer the follow-up, the more cost-effective Visudyne was. Cost-effectiveness is a country-dependent assessment and analyses should be done for each health care system.


CONCLUSIONS
PDT was found to be cost-effective in Switzerland (category C of Laupaci's classification).
Donati
G
G
Service d'Ophtalmologie, Hôpitaux Universitaires de Genève. guy_donati@bluewin.ch
D003362:Cost-Benefit Analysis; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy* / Q000191:economics; D008390:Markov Chains; D010778:Photochemotherapy / Q000191:economics*; D017319:Photosensitizing Agents / Q000191:economics / Q000627:therapeutic use; D011166:Porphyrins / Q000191:economics* / Q000627:therapeutic use; D011446:Prospective Studies; D013557:Switzerland; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin