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    Does quality-of-life with DME therapies have a price?

    Take-home: In DME patients with worse baseline visual acuity, aflibercept and ranibizumab provided more of a quality-of-life improvement—yet aflibercept had an associated higher cost.

    In diabetic macular edema (DME) patients with worse visual acuity, intravitreal agents aflibercept (Eylea, Regneron) and ranibizumab (Lucentis, Genentech) had higher quality-of-life benefits compared with bevacizumab (Avastin, Genentech). However, ranibizumab had a slightly greater gain in DME patients with better visual acuity, with an associated lower cost compared to aflibercept.

    Related: Tie2 activator augments anti-VEGF for DME

    Bryan K. Hong, MD, presented these conclusions based on a value-based medicine analysis of research from the Diabetic Retinopathy Clinical Research Network, Protocol T (Years 1 and 2), which compares aflibercept, ranibizumab, and bevacizumab in a randomized manner.1,2  Protocol T tracked the efficacy of the various agents as well as the average number of injections for patients.

    Dr. Hong, MD, is a vitreoretinal fellow at the Wills Eye Hospital, Thomas Jefferson University, Philadelphia.

    Dr. Hong’s work is based on methodology developed by Gary Brown, MD, and Melissa Brown, MD, both of Thomas Jefferson University, who were able to assign time-trade off utilities to specific visual acuity levels, thereby allowing the comparison of value-based efficacy across all medical specialties in a way that is understandable by the public.3,4,5

    Related: DME therapy with plasma kallikrein inhibitor showing promise

    Value-based medicine considers patient value gain and financial value gain by looking at factors, such as quality of life (QOL), length of life, adverse effects, benefits, and patient opinions.

    QOL issue

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