title: Cost and effectiveness of therapy for wet age-related macular degeneration in routine clinical practice.
abstract: OBJECTIVE
  Evaluation of the cost and effectiveness of therapy for patients with the wet form of age-related macular degeneration (AMD) in routine clinical practice.
  
  
  METHODS
  A retrospective multicentre evaluation of changes in the best-corrected visual acuity in applied kinds of therapy and a comparison with the cost of individual therapeutic procedures.
  
  
  RESULTS
  An overall total of 788 eyes of 763 patients with an average age of 73.2 ± 8.6 years was evaluated for a 1-year minimum period. In the ranibizumab and pegaptanib therapy groups, a reduction of 1.3 letters (p = 0.303) and 1.4 letters (p = 0.197) was found, respectively. In the group of photodynamic therapy (PDT) with verteporfin, a reduction of 5.2 letters was achieved (p < 0.001). Under the conditions of routine practice in the Czech Republic, the annual cost is highest (EUR 5,467.63/patient) in patients with pegaptanib therapy. The annual cost in patients with ranibizumab therapy is lower by EUR 1,220.16. The cost is nearly half (EUR 2,783.65) in the group treated with PDT with verteporfin.
  
  
  CONCLUSIONS
  An initiation of AMD therapy by ranibizumab is cost-effective as compared to pegaptanib. Both ranibizumab and pegaptanib are significantly more efficient as compared to PDT with verteporfin. Therapy with ranibizumab and pegaptanib, as compared to PDT with verteporfin, prevents the loss of 1 line of vision on the ETDRS chart for EUR 1,225.98 and 2,286.18, respectively.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine in Hradec Králové, Charles University in Prague, and University Hospital, Hradec Králové, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Studnička
authors.forename: Barbora
authors.initials: B
authors.lastname: Říhová
authors.forename: Eva
authors.initials: E
authors.lastname: Rencová
authors.forename: Pavel
authors.initials: P
authors.lastname: Rozsíval
authors.forename: Zora
authors.initials: Z
authors.lastname: Dubská
authors.forename: Oldřich
authors.initials: O
authors.lastname: Chrapek
authors.forename: Petr
authors.initials: P
authors.lastname: Kolář
authors.forename: Vít
authors.initials: V
authors.lastname: Kandrnal
authors.forename: Regina
authors.initials: R
authors.lastname: Demlová
authors.forename: Šárka
authors.initials: Š
authors.lastname: Pitrová
authors.forename: Jiří
authors.initials: J
authors.lastname: Řehák
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000191:economics / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics / Q000627:therapeutic use*; D052157:Aptamers, Nucleotide / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000191:economics; D017319:Photosensitizing Agents / Q000191:economics / Q000627:therapeutic use; D011166:Porphyrins / Q000191:economics / Q000627:therapeutic use*; D000069579:Ranibizumab; D012189:Retrospective Studies; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; C495058:pegaptanib; D000069579:Ranibizumab