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Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data

Lee, AY; Butt, T; Chew, E; Agron, E; Clemons, TE; Egan, CA; Lee, CS; (2018) Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data. British Journal of Ophthalmology , 102 (4) pp. 465-472. 10.1136/bjophthalmol-2017-310939. Green open access

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Abstract

Aims To evaluate the cost-effectiveness of Age-Related Eye Disease Study (AREDS) 1 & 2 supplements in patients with either bilateral intermediate age-related macular degeneration, AREDS category 3, or unilateral neovascular age-related macular degeneration AMD (nAMD), AREDS category 4. Methods A patient-level health state transition model based on levels of visual acuity in the better-seeing eye was constructed to simulate the costs and consequences of patients taking AREDS vitamin supplements. Setting: UK National Health Service (NHS). The model was populated with data from AREDS and real-world outcomes and resource use from a prospective multicentre national nAMD database study containing 92 976 ranibizumab treatment episodes. Interventions Two treatment approaches were compared: immediate intervention with AREDS supplements or no supplements. Main outcome measures: quality-adjusted life years (QALYs) and healthcare costs were accrued for each strategy, and incremental costs and QALYs were calculated for the lifetime of the patient. One-way and probabilistic sensitivity analyses were employed to test the uncertainty of the model. Results For AREDS category 3, the incremental cost-effectiveness ratio was £30 197. For AREDS category 4 compared with no intervention, AREDS supplements are more effective (10.59 vs 10.43 QALYs) and less costly (£52 074 vs 54 900) over the lifetime of the patient. Conclusions The recommendation to publicly fund AREDS supplements to category 3 patients would depend on the healthcare system willingness to pay. In contrast, initiating AREDS supplements in AREDS category 4 patients is both cost saving and more effective than no supplement use and should therefore be considered in public health policy.

Type: Article
Title: Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bjophthalmol-2017-310939
Publisher version: http://doi.org/10.1136/bjophthalmol-2017-310939
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10048625
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