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We assessed its cost\u2010effectiveness for reducing the progression of diabetic retinopathy versus standard care from a UK National Health Service perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Resource use and outcome data were collected over follow\u2010up for participants enrolled in LENS. Mean costs were compared at 2\u2009years and per 6\u2010month follow\u2010up (median 4.0\u2009years). Within the trial, cost\u2010effectiveness was assessed in terms of the incremental cost per case of referable disease averted. A microsimulation model, with inputs derived primarily from LENS trial data, was used to assess the incremental cost per quality\u2010adjusted life year (QALY).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fenofibrate resulted in a mean (95% confidence interval) reduction in health service costs of \u2010\u00a3254 (\u22121062 to 624) at 2\u2009years and \u2010\u00a3101 (\u2212243 to 42) per 6\u2010month follow\u2010up. This was accompanied by a 4.4% (1.3% to 8.0%) absolute reduction in any referable diabetic retinopathy or treatment thereof at 2 years, and a 27% (9%\u201342%) relative reduction over follow\u2010up. Modelled over 10\u2009years, fenofibrate use cost an additional \u00a36 per patient for an expected QALY gain of 0.02, costing \u00a3406 per QALY versus standard care under base case assumptions. The probability of cost\u2010effectiveness varied from 70% to 79% at a threshold of \u00a320,000 per QALY, depending on the price discount applied to anti\u2010VEGF drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fenofibrate is likely to offer a cost\u2010effective treatment for slowing the progression of diabetic retinopathy in people with early to moderate diabetic retinopathy or maculopathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.70098","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T12:09:43Z","timestamp":1751544583000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost\u2010effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the <scp>LENS<\/scp> trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5539-8819","authenticated-orcid":false,"given":"Graham","family":"Scotland","sequence":"first","affiliation":[{"name":"Health Economics Research Unit University of Aberdeen  Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mekazin","family":"Tsehaye","sequence":"additional","affiliation":[{"name":"Health Economics Research Unit University of Aberdeen  Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Styles","sequence":"additional","affiliation":[{"name":"Queen Margaret Hospital  Fife UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Logue","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine University of Lancaster  Lancaster UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Sammons","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9816-983X","authenticated-orcid":false,"given":"Mohammed","family":"Zayed","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Emberson","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Wade","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Wallendszus","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Will","family":"Stevens","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosanna","family":"Cretney","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Harding","sequence":"additional","affiliation":[{"name":"Department of eye and Vision Science, University of Liverpool and St. Paul's Eye Unit Liverpool University Hospitals NHS Foundation Trust  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"Leese","sequence":"additional","affiliation":[{"name":"Molecular and Clinical Medicine University of Dundee  Dundee UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Currie","sequence":"additional","affiliation":[{"name":"School of Cardiovascular &amp; Metabolic Health University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Armitage","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3139-1836","authenticated-orcid":false,"given":"David","family":"Preiss","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health, University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the LENS Collaborative Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.9.2653"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004015"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01687-w"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-020-0961-6"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/08820538.2017.1353820"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjophth-2022-001068"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61607-9"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001288"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2400179"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15310"},{"key":"e_1_2_10_12_1","unstructured":"JonesKC BurnsA.Unit costs of health and social care 2022. 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