Evidence map›Paper›PMID 40481910›Full record

SynthesisAdvances in therapy2025

Anti-VEGFs for Diabetic Macular Oedema: Analysis of Efficacy, Safety, and Cost of More Durable Therapies from a Dutch Societal Perspective.

Sara W Quist, Jeroen H J Paulissen, Izabella Lunk, Joao Carrasco, Marrit A Woudstra, Michal Pochopien, Mateusz Nikodem, Catriona Crossan, Sankha Amarakoon, Freekje van Asten and 1 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Advances in therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

11 authors.

Sara W QuistDepartment of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands. s.w.quist@umcg.nl.ORCID http://orcid.org/0000-0003-3871-4239
Jeroen H J PaulissenDepartment of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands.
Izabella LunkBayer AG, Basel, Switzerland.
Joao CarrascoBayer AG, Basel, Switzerland.
Marrit A WoudstraBayer Pharmaceuticals, Hoofddorp, Netherlands.
Michal PochopienClever Access, Cracow, Poland.
Mateusz NikodemPutnam PHMR, Cracow, Poland.
Catriona CrossanPutnam PHMR, London, UK.
Sankha AmarakoonUniversity Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands.
Freekje van AstenUniversity Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands.
Maarten J PostmaDepartment of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFrequent intravitreal injections of anti-vascular endothelial growth factors (VEGFs) for diabetic macular oedema (DMO) pose challenges for healthcare systems, patients, and society. This study assessed the efficacy, safety, resource utilization, and costs of anti-VEGFs from a Dutch societal perspective.

methodsA systematic literature review and indirect treatment comparison (ITC) compared the efficacy and safety of aflibercept 8 mg with aflibercept 2 mg, ranibizumab, faricimab, and bevacizumab. A Markov model estimated lifetime costs for unilateral or bilateral DMO treatment over 5 years from a Dutch societal perspective. Break-even prices determined the cost-neutral price for each anti-VEGF compared to the least expensive option.

resultsThe ITC found no significant differences in efficacy or safety among anti-VEGFs, leading to a cost-minimisation analysis. Over 5 years, the mean number of injections ranged from 15.0 (aflibercept 8 mg, flexible Q16 regimen) to 24.9 (bevacizumab, pro re nata regimen). Bevacizumab had the lowest 5-year per-patient cost (€80,315). Aflibercept 8 mg followed at €83,577, with a break-even price of €560 per injection (- 23% vs. current price). Aflibercept 2 mg (fixed regimen), faricimab, and ranibizumab (treat-and-extend) required price reductions of 74%, 63%, and 71%, respectively, to match bevacizumab.

conclusionDespite similar efficacy and safety, differences in treatment burden were identified among the anti-VEGFs, with the more durable regimen of aflibercept 8 mg potentially reducing overall injection frequency compared to current care. Nevertheless, on the basis of current list prices, bevacizumab is the least expensive anti-VEGF for treating DMO. Aflibercept 8 mg, aflibercept 2 mg, faricimab, and ranibizumab could achieve cost-equivalence to bevacizumab if their medication prices were reduced by at least 23%, 74%, 63%, and 71%. These results could support future decision-making of healthcare providers and payers, encompassing aspects of medical costs, healthcare capacity use, and burden on patients as well as the healthcare system as a whole.

Indexed as

Angiogenesis InhibitorsDiabetic RetinopathyMacular EdemaVascular Endothelial Growth Factor AAntibodies, Monoclonal, HumanizedBevacizumabCost-Benefit AnalysisHumansIntravitreal InjectionsMarkov ChainsNetherlandsRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsTreatment OutcomeafliberceptAngiogenesis InhibitorsAntibodies, Monoclonal, HumanizedBevacizumabRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor AAnti-VEGFsCost-minimisationDiabetic macular oedemaIndirect treatment comparison

Identifiers

PMID40481910
PMCPMC12313814

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

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.