{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:50:28Z","timestamp":1781887828815,"version":"3.54.5"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The adoption of biologic therapies imposes a substantial financial burden on the Jordanian healthcare system. ranibizumab is prescribed for various retinal disorders, and its associated costs are considerable. The introduction of biosimilars is beneficial in retaining desired clinical parameters while providing cost relief and enhanced access to patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the budget impact and expanded access of switching to ranibizumab\u2019s biosimilar for the management of retinal diseases in guideline-based practice and in real-world practice in Jordan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A 4-year budget impact analysis from Jordanian public sector payer\u2019s sector was performed (2023 to 2026) that included patient prevalence and incidence, average ranibizumab dose per year, and anticipated shifts in the market share of ranibizumab and aflibercept. The model took into account the anticipated price erosion of the biosimilar in 2025 and 2026. Sensitivity analyses were performed to assess the effect of changes in uptake rates, price, and market share.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The annual cost savings per patient when switching from aflibercept to ranibizumab\u2019s biosimilar were from 20.55 JOD (Jordanian Dinar) to 1519.93 JOD, translating to a percentage saving of 2.68 to 35.12% across the various scenarios and indications. The total budget impact ranged widely from 6.9\u202fM JOD to 21.2\u202fM JOD based on treatment regimens adjusted to current practice, PRN (Pro re nata), or T&amp;amp;E (Treat and extend). Patient access improved between 2.75 to 124.76% in the different scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The introduction of ranibizumab\u2019s biosimilar significantly reduces the expenditures and enhances treatment access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1800784","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:41:47Z","timestamp":1778132507000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Budget impact analysis of the introduction of ranibizumab\u2019s biosimilar to the Jordanian joint procurement system"],"prefix":"10.3389","volume":"14","author":[{"given":"Jalal Abu","family":"Hamida","sequence":"first","affiliation":[{"name":"Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimer S.","family":"Alkhatib","sequence":"additional","affiliation":[{"name":"Al-Zaytoonah University of Jordan Faculty of Pharmacy","place":["Amman, Jordan"]},{"name":"Path Economics, LLC","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khawla Abu","family":"Hammour","sequence":"additional","affiliation":[{"name":"Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiraz","family":"Halloush","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy and Therapeutics Department, Faculty of Pharmacy, Applied Science Private University","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanj","family":"Kurdi","sequence":"additional","affiliation":[{"name":"University of Strathclyde Institute of Pharmacy and Biomedical Sciences","place":["Glasgow, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bander","family":"Balkhi","sequence":"additional","affiliation":[{"name":"King Saud University College of Pharmacy","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamah M.","family":"Alfayez","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, Qassim University","place":["Qassim, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rimal","family":"Mousa","sequence":"additional","affiliation":[{"name":"Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan","place":["Amman, Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.2147\/OPTH.S257460","article-title":"A multicenter, cross-sectional study of the incidence of major macular diseases that cause visual impairment in Greece: the ADVICE study","volume":"14","author":"Karagiannis","year":"2020","journal-title":"Clin Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1007\/s40123-025-01104-3","article-title":"Clinical and socioeconomic burden of retinal diseases: can biosimilars add value? A narrative review","volume":"14","author":"Hariprasad","year":"2025","journal-title":"Ophthalmol Therapy"},{"key":"ref3","year":"2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"161","DOI":"10.2147\/ceor.S454185","article-title":"The economic burden of diabetic retinopathy in Jordan: cost analysis and associated factors","volume":"16","author":"Al-Dwairi","year":"2024","journal-title":"Clinicoecon Outcomes Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1016\/s0161-6420(84)34102-1","article-title":"The Wisconsin epidemiologic study of diabetic retinopathy IV Diabetic macular edema","volume":"91","author":"Klein","year":"1984","journal-title":"Ophthalmology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1886","DOI":"10.1111\/j.1538-7836.2010.03909.x","article-title":"Retinal vein thrombosis: pathogenesis and management","volume":"8","author":"Rehak","year":"2010","journal-title":"J Thromb Haemost"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"010427","DOI":"10.7189\/jogh.09.010427","article-title":"Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors","volume":"9","author":"Song","year":"2019","journal-title":"J Glob Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e106","DOI":"10.1016\/s2214-109x(13)70145-1","article-title":"Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis","volume":"2","author":"Wong","year":"2014","journal-title":"Lancet Glob Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1080\/07853890600946724","article-title":"Age-related macular degeneration\u2014emerging pathogenetic and therapeutic concepts","volume":"38","author":"Gehrs","year":"2006","journal-title":"Ann Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/pcgv5709","article-title":"Anti-VEGF drugs compared with laser photocoagulation for the treatment of diabetic retinopathy: a systematic review and meta-analysis","volume":"29","author":"Simmonds","year":"2024","journal-title":"Health Technol Assess"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"22","DOI":"10.56920\/cehj.835","article-title":"Biosimilars for anti-VEGF treatment of macular diseases: country and region reports","volume":"37","author":"Cano","year":"2025","journal-title":"Community Eye Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.jval.2013.08.2291","article-title":"Budget impact analysis\u2014principles of good practice: report of the ISPOR 2012 budget impact analysis good practice II task force","volume":"17","author":"Sullivan","year":"2014","journal-title":"Value Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"527","DOI":"10.2147\/ceor.S265041","article-title":"Budget impact analysis of switching to rituximab's biosimilar in rheumatology and cancer in 13 countries within the Middle East and North Africa","volume":"12","author":"Almaaytah","year":"2020","journal-title":"Clinicoecon Outcomes Res"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1080\/14737167.2021.1927716","article-title":"Budget impact analysis of medicines: estimated values versus real-world evidence and the implications","volume":"22","author":"Faleiros","year":"2022","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2376","DOI":"10.1016\/j.ophtha.2016.07.032","article-title":"Intravitreal aflibercept for diabetic macular edema: 148-week results from the VISTA and VIVID studies","volume":"123","author":"Heier","year":"","journal-title":"Ophthalmology"},{"key":"ref16","year":"2017"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"25158414231195174","DOI":"10.1177\/25158414231195174","article-title":"Three-year outcomes of intravitreal ranibizumab and aflibercept treatment of patients with diabetic macular edema: a comparative study","volume":"15","author":"Akbas","year":"2023","journal-title":"Ther Adv Ophthalmol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1102","DOI":"10.1016\/j.ophtha.2010.02.021","article-title":"Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study","volume":"117","author":"Campochiaro","year":"2010","journal-title":"Ophthalmology"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.1016\/j.ophtha.2012.09.006","article-title":"Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration","volume":"119","author":"Heier","year":"2012","journal-title":"Ophthalmology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/s12886-020-01397-x","article-title":"Individualized treat-and-extend regime for optimization of real-world vision outcome and improved patients\u2019 persistence","volume":"20","author":"Volkmann","year":"2020","journal-title":"BMC Ophthalmol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e0312603","DOI":"10.1371\/journal.pone.0312603","article-title":"Budget impact analysis of subcutaneous infliximab (CT-P13 SC) for treating inflammatory bowel disease in Saudi Arabia: analysis from payer perspective","volume":"19","author":"Alkhatib","year":"2024","journal-title":"PLoS One"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1080\/13696998.2020.1760284","article-title":"Economic modeling for the US of the cost-efficiency and associated expanded treatment access of conversion to biosimilar pegfilgrastim-bmez from reference pegfilgrastim","volume":"23","author":"McBride","year":"2020","journal-title":"J Med Econ"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.ajo.2020.05.029","article-title":"Cost-utility analysis of VEGF inhibitors for treating neovascular age-related macular degeneration","volume":"218","author":"Brown","year":"2020","journal-title":"Am J Ophthalmol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s12325-019-01147-6","article-title":"Real-world effectiveness and real-world cost-effectiveness of intravitreal aflibercept and intravitreal ranibizumab in neovascular age-related macular degeneration: systematic review and meta-analysis of real-world studies","volume":"37","author":"Carrasco","year":"2020","journal-title":"Adv Ther"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e005094","DOI":"10.1136\/bmjopen-2014-005094","article-title":"Cost-effectiveness of ranibizumab and bevacizumab for age-related macular degeneration: 2-year findings from the IVAN randomised trial","volume":"4","author":"Dakin","year":"2014","journal-title":"BMJ Open"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.vhri.2019.09.007","article-title":"Cost-minimization analysis of ranibizumab versus aflibercept for treating Saudi patients with visual impairment owing to age-related macular degeneration or diabetic macular edema","volume":"22","author":"El-Dahiyat","year":"2020","journal-title":"Value Health Reg Issues"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"608","DOI":"10.18553\/jmcp.2018.24.7.608","article-title":"Intravitreal aflibercept versus ranibizumab for wet age-related macular degeneration: a cost-effectiveness analysis","volume":"24","author":"Hernandez","year":"2018","journal-title":"J Manag Care Spec Pharm"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1080\/13696998.2019.1666855","article-title":"Cost-effectiveness of ranibizumab and aflibercept to treat diabetic macular edema from a US perspective: analysis of 2-year protocol T data","volume":"23","author":"Holekamp","year":"2020","journal-title":"J Med Econ"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e00145518","DOI":"10.1590\/0102-311x00145518","article-title":"Budget impact of the incorporation of second-line drug treatment for diabetic macular edema in the Brazilian unified National Health System from the perspective of the Minas Gerais state health department, Brazil","volume":"35","author":"Izidoro","year":"2019","journal-title":"Cad Saude Publica"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1001\/jamaophthalmol.2016.1669","article-title":"Cost-effectiveness of aflibercept, bevacizumab, and ranibizumab for diabetic macular edema treatment: analysis from the diabetic retinopathy clinical research network comparative effectiveness trial","volume":"134","author":"Ross","year":"2016","journal-title":"JAMA Ophthalmol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"97","DOI":"10.36469\/001c.129832","article-title":"Cost-effectiveness and budget impact analysis of the use of faricimab in diabetic macular edema and neovascular age-related macular degeneration in Colombia","volume":"12","author":"Samac\u00e1-Samac\u00e1","year":"2025","journal-title":"J Health Econ Outcomes Res"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1016\/j.ophtha.2013.10.037","article-title":"Cost-effectiveness of bevacizumab and ranibizumab for newly diagnosed neovascular macular degeneration","volume":"121","author":"Stein","year":"2014","journal-title":"Ophthalmology"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1001\/jamaophthalmol.2015.4110","article-title":"Comparison of aflibercept, bevacizumab, and ranibizumab for treatment of diabetic macular edema: extrapolation of data to clinical practice","volume":"134","author":"Heier","year":"","journal-title":"JAMA Ophthalmol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1080\/13696998.2021.2007705","article-title":"Comparing jurisdiction-specific pharmaco-economic evaluations using medical purchasing power parities","volume":"24","author":"Choi","year":"2021","journal-title":"J Med Econ"}],"updated-by":[{"DOI":"10.3389\/fpubh.2026.1877974","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000}},{"DOI":"10.3389\/fpubh.2026.1903188","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000}}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1800784\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:49:43Z","timestamp":1781884183000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1800784\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":34,"alternative-id":["10.3389\/fpubh.2026.1800784"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1800784","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"article-number":"1800784"}}