Pharmacoeconomic analysis of switch to faricimab for neovascular age-related macular degeneration in real clinical practice

Introduction: Neovascular age-related macular degeneration (nAMD) is one of the leading causes of severe vision loss among older adults. This condition impairs patients' quality of life and imposes a significant economic burden on the healthcare system. This study aims to determine the difference in direct healthcare cost (DHC) after switching the current pharmacological treatment in patients with nAMD, under a treat-and-extend regimen, to faricimab. Methods: Treatment interval data obtained after switching to faricimab in 225 eyes with nAMD was used to calculate total DHC in comparison with the theoretical DHC had if patients remained on their previous treatment (drug and treatment interval). An "optimal responder" was defined as a patient whose interval between intravital injections was extended by more than 8 weeks relative to the baseline treatment interval. Results: The theoretical DHC of treatment for this series of nAMD eyes would have been €2,351,241.90, compared with an actual DHC after switching to faricimab of €1,718,015.83, representing a saving of €633,226.06 for 225 eyes. The mean theoretical DHC would have been €10,449.96 ± 4,340.18 (from 1,423.75 to 23,695.20), compared with a mean actual total cost of €7,635.62 ± 2,465.07 (from 2,571.88 to 15,431.28). The mean actual DHC was €8,499.74 ± 2,678.42 in the "non-optimal responder" group versus €6,593.59 ± 1,674.91 in the "optimal responder" group (p < 0.001). Conclusion: Switching to faricimab in patients with nAMD on a treat-and-extend regimen with a treatment interval of less than 12 weeks resulted in a significant reduction in total DHC, particularly in the "optimal responder" group.