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Neovascular AMD (nAMD) is an advanced stage of AMD treated with anti-vascular endothelial growth factors (anti-VEGFs). Although anti-VEGF treatment is effective, the frequent intravitreal injections place a burden on patients, (in)formal caregivers, and clinics. This study assesses the health-economic impact of anti-VEGF agents with lower injection frequency that have the potential to reduce treatment burden and compares it to the standard of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a cost-minimization model to evaluate the direct medical costs associated with first-line unilateral anti-VEGF treatment across a 3-year time horizon in the Netherlands. The analysis compared aflibercept 8\u00a0mg, aflibercept 2\u00a0mg, bevacizumab, faricimab, and ranibizumab. Our model adopted a treat-and-extend (T&amp;E) regimen for aflibercept 2\u00a0mg, bevacizumab, and ranibizumab. For aflibercept 8\u00a0mg, a flexible regimen that was extendable up to 24\u00a0weeks was applied, while faricimab followed a flexible regimen that was extendable up to 16\u00a0weeks. Additionally, since list prices may vary from net prices, we calculated the break-even price for each anti-VEGF in comparison to bevacizumab, which is the recommended first-line treatment due to its low medication price.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on list prices, aflibercept 8\u00a0mg led to the lowest treatment costs (\u20ac16,251 per patient over a 3-year time horizon), closely followed by bevacizumab (\u20ac17,616 per patient over a 3-year time horizon). Ranibizumab led to the highest per-patient costs (\u20ac31,746 over a 3-year time horizon). For bevacizumab, most costs were attributable to administration, while for the other anti-VEGFs, most were attributable to medication. Aflibercept 8\u00a0mg is cost-saving compared to bevacizumab at their medication prices at the time of writing. Aflibercept 2\u00a0mg, faricimab, and ranibizumab should be priced below \u20ac488, \u20ac591, and \u20ac75, respectively. To be cost-equal to bevacizumab with current list prices, anti-VEGFs should be administered with a maximum of 12.7 to 13.8 injections over a 3-year time horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>According to the injection frequency observed in clinical trials, aflibercept 8\u00a0mg would be the anti-VEGF that generates the lowest per-patient healthcare costs for the treatment of nAMD in the Netherlands after a treatment period of three years. Our study indicates that anti-VEGF drugs with a lower injection frequency might provide a cost-saving solution to the increasing burden of anti-VEGF treatment on the healthcare system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-024-06588-6","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T17:26:33Z","timestamp":1727285193000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3871-4239","authenticated-orcid":false,"given":"Sara W.","family":"Quist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidde","family":"Nab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Postma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sankha","family":"Amarakoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freekje","family":"van Asten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel","family":"Freriks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,25]]},"reference":[{"key":"6588_CR1","unstructured":"Volksgezondheidsinfo (2021) Gezichtsstoornissen | Leeftijd en geslacht | Maculadegeneratie. https:\/\/www.vzinfo.nl\/gezichtsstoornissen-leeftijd-en-geslacht-maculadegeneratie. 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MJP received grants and honoraria from various pharmaceutical companies, all unrelated to this work and reports stocks of and advisorships for PAG BV, Health-Ecore and ASC Academics (all in Groningen, The Netherlands). SA performed consultancy work for Novartis, Bayer, horus pharma, and Roche. FvA has no conflicts of interest to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}