Economic Benefit of Aflibercept 8 mg Versus Faricimab for Neovascular Age-Related Macular Degeneration or Diabetic Macular Edema in the US

The aim of this study was to compare the estimated direct and indirect costs with aflibercept 8 mg and faricimab in patients with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME) over 5 years. An economic model was developed to estimate direct and indirect costs based on the mean number of injections administered in clinical trials of aflibercept 8 mg (PULSAR and PHOTON) and faricimab (TENAYA/LUCERNE and YOSEMITE/RHINE). Injection numbers for years 1 and 2 were sourced from clinical trials, injection numbers in years 3–5 were imputed from year 2, and the base case for the analysis was a 3-year time horizon. Direct costs were estimated based on modeled mean injection numbers and 2025 wholesale acquisition costs per injection (aflibercept 8 mg: 2677.50 USD; faricimab: 2289.65 USD) plus medical monitoring costs. Indirect costs included caregiver and patient time and travel costs. Over a 3-year time horizon, the mean number of injections was lower with aflibercept 8 mg versus faricimab for nAMD (12.25 vs. 14.80 injections) and DME (11.80 vs. 15.65 injections). Total costs (direct and indirect) associated with aflibercept 8 mg were 1978.74 USD lower than faricimab for nAMD and 6032.90 USD lower than faricimab for DME. After year 1, similar differences were seen through 5 years. For both nAMD and DME, less frequent dosing with aflibercept 8 mg versus faricimab is expected to reduce the direct and indirect cost burden to payers and patients.