title: Cost comparison of intravitreal aflibercept with bevacizumab and ranibizumab for the treatment of wet age-related macular degeneration.
abstract: OBJECTIVE
  To test the hypothesis that although intravitreal aflibercept (IVA) is expected to be more expensive, the extra cost of treatment would not result in additional vision gain compared with intravitreal bevacizumab (IVB) for the treatment of wet age-related macular degeneration (AMD).
  
  
  METHODS
  A retrospective chart review of patients receiving IVB or intravitreal ranibizumab (IVR) who were subsequently changed to IVA for active wet AMD.
  
  
  RESULTS
  Thirty-three eyes were included in the study. The mean number of IVB, IVR, and IVA injections per eye over a 6-month period was seven, six, and five, respectively. Visual outcomes were similar in all three groups at the end of the study period. The average drug cost of IVB, IVR, and IVA injections per eye over 6 months was $326, $11,400, and $9,720, respectively.
  
  
  CONCLUSIONS
  Aflibercept may allow a modest extension of the treatment interval, but cost makes IVA an expensive alternative without a visual benefit compared with IVB in patients with active wet AMD.
authors.forename: Adeel H
authors.initials: AH
authors.lastname: Shaikh
authors.forename: Brian W
authors.initials: BW
authors.lastname: Toussaint
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Miller
authors.forename: Michael R
authors.initials: MR
authors.lastname: Petersen
authors.forename: Robert E
authors.initials: RE
authors.lastname: Foster
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Riemann
authors.forename: Robert K
authors.initials: RK
authors.lastname: Hutchins
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sisk
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; D000068258:Bevacizumab; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D057915:Drug Substitution; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000191:economics* / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy / Q000191:economics* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab