Evidence mapPaperPMID 39910280Full record

ArticleEye (London, England)2025

A Markov model assessing the cost-effectiveness of various anti-vascular endothelial growth factor drugs and panretinal photocoagulation for the treatment of proliferative diabetic retinopathy.

Kirsty Luckham, Hannah Tebbs, Lindsay Claxton, Philip Burgess, Christiana Dinah, Noemi Lois, Syed Mohiuddin

Abstract read
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Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. The CAPA framework: a conceptual model integrating corrective and preventive strategies for retinal ischemia and neovascularization.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kirsty LuckhamScience, Evidence and Analytics Directorate, National Institute for Health and Care Excellence, London, UK. kirsty.luckham@nice.org.uk.ORCID http://orcid.org/0009-0009-2131-6243
Hannah TebbsScience, Evidence and Analytics Directorate, National Institute for Health and Care Excellence, London, UK.
Lindsay ClaxtonScience, Evidence and Analytics Directorate, National Institute for Health and Care Excellence, London, UK.
Philip Burgess *Department of Eye and Vision Science, University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Christiana Dinah *Research and Innovation, London North West University Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-0815-4771
Noemi Lois *School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.ORCID http://orcid.org/0000-0003-2666-2937
Syed MohiuddinScience, Evidence and Analytics Directorate, National Institute for Health and Care Excellence, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProliferative diabetic retinopathy (PDR) may lead to vision loss and blindness. The cost-effectiveness of various anti-vascular endothelial growth factor (anti-VEGF) drugs and panretinal photocoagulation (PRP) was assessed to supplement the NICE guideline for treating PDR.

methodsA Markov model including eight levels of visual acuity (ranged between >85 and ≤25 letters) was developed to compare the cost-effectiveness of ranibizumab, aflibercept and bevacizumab with PRP (alone or in combination). Clinical inputs in the model were based on literature, while a published network meta-analysis (NMA) informed visual outcomes. Costs were estimated from a UK NHS perspective.

resultsAssuming initial treatment effects from the NMA continued to be applied for the remainder of lifetime, the probabilistic analysis resulted in bevacizumab plus PRP producing the highest net monetary benefit (NMB [95% CI]) of £221,374 [£203,941-£238,388] at £20,000 per quality-adjusted life-year. However, assuming initial treatment effects stabilised over time resulted in PRP alone producing the highest NMB of £223,416 [£209,318-£236,866]. Results were associated with large uncertainty due to wide confidence intervals around vision-based treatment effects of anti-VEGFs versus PRP, particularly for bevacizumab as data were drawn from trials with small sample size and high risk of bias. Using confidential prices for aflibercept and ranibizumab did not change the overall findings.

conclusionsPRP is likely to be more cost-effective than anti-VEGFs for PDR. However, the results should be interpreted with caution given the scarcity of long-term visual outcomes with anti-VEGFs in this population. Further research on long-term visual outcomes may resolve these uncertainties.

Indexed as

Angiogenesis InhibitorsDiabetic RetinopathyLaser CoagulationVascular Endothelial Growth Factor ABevacizumabCost-Benefit AnalysisHumansIntravitreal InjectionsMarkov ChainsQuality-Adjusted Life YearsRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsUnited KingdomVisual AcuityafliberceptAngiogenesis InhibitorsBevacizumabRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor AVEGFA protein, human

Identifiers

PMID39910280
PMCPMC12043813

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.