Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population

Subhasish Pramanik,1 Lakshmi Kanta Mondal,2 Suman Kalyan Paine,3 Sneha Jain,2 Subhankar Chowdhury,1 Upasana Ganguly,4 Sayantan Ghosh,2 Chiranjit Bose,1 Koena Bhattacharjee,2 Gautam Bhaduri5 1Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, 700020, India; 2Regional Institu...

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Autores principales:	Pramanik S, Mondal LK, Paine SK, Jain S, Chowdhury S, Ganguly U, Ghosh S, Bose C, Bhattacharjee K, Bhaduri G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic retinopathy diabetic macular edema ranibizumab bevacizumab laser therapy cost-effectiveness Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2fd35cb97e8740b79153db352c5d50d4
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spelling	oai:doaj.org-article:2fd35cb97e8740b79153db352c5d50d42021-12-02T16:26:43ZEfficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population1177-5483https://doaj.org/article/2fd35cb97e8740b79153db352c5d50d42021-08-01T00:00:00Zhttps://www.dovepress.com/efficacy-and-cost-effectiveness-of-anti-vegf-for-treating-diabetic-ret-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Subhasish Pramanik,1 Lakshmi Kanta Mondal,2 Suman Kalyan Paine,3 Sneha Jain,2 Subhankar Chowdhury,1 Upasana Ganguly,4 Sayantan Ghosh,2 Chiranjit Bose,1 Koena Bhattacharjee,2 Gautam Bhaduri5 1Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, 700020, India; 2Regional Institute of Ophthalmology (RIO), Medical College and Hospital, Kolkata, 700073, India; 3National Institute of Biomedical Genomics (NIBMG), Kalyani, West Bengal, India; 4Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India; 5MGM Medical College, Kishanganj, Bihar, IndiaCorrespondence: Lakshmi Kanta MondalRegional Institute of Ophthalmology, Medical College, Kolkata, IndiaTel +91 9830830216Email Lakshmi.mondal62@gmail.comPurpose: In the present study, we aimed to evaluate the efficacy, safety, and cost-effectiveness of the anti-vascular endothelial growth factor (anti-VEGF), namely ranibizumab (RBZ) or bevacizumab (BVZ), after either focal or grid or scatter laser photocoagulation, for the treatment of diabetic macular edema (DME) in the Indian population.Methods: Retrospective data were collected in the Regional Institute of Ophthalmology, Kolkata, India between January 2018 and June 2019. Seventy-seven eyes received 3 consecutive monthly intravitreal injections of RBZ (0.5 mg) and were followed by prompt laser photocoagulation (within 7– 10 days after the third injection). Similarly, 51 eyes received 3 consecutive monthly intravitreal injections of BVZ (1.25 mg), an off-label drug, and were followed by prompt laser therapy. Safety assessments of the therapy, as well as surrogate markers of biochemical derangements related to diabetic retinopathy (DR), were also investigated at the end of 12 months.Results: Seventy-seven subjects who were given a treatment of RBZ+laser therapy showed average 6.87± 5.53 letters gain in their best-corrected visual acuity (BCVA) score, whereas the ones treated with off-label BVZ+ laser therapy demonstrated improvement in BCVA of an average 6.82± 5.76 letters in “Early Treatment Diabetic Retinopathy Study” (ETDRS) chart. The study also highlights the cost-effectiveness of both RBZ+laser and BVZ+laser therapies for the treatment of DME in DR. The results demonstrated that a subject has to pay 20.951 times more cost (in INR) for RBZ+laser therapy compared to BVZ+laser therapy, to get an almost similar outcome.Conclusion: BVZ is found to be the more attractive option for treating DME in DR for its cost-friendliness over RBZ in terms of BCVA outcome, as well as the safety perspectives, at least for the economically backward population in developing countries, like India.Keywords: diabetic retinopathy, diabetic macular edema, ranibizumab, bevacizumab, laser therapy, cost-effectivenessPramanik SMondal LKPaine SKJain SChowdhury SGanguly UGhosh SBose CBhattacharjee KBhaduri GDove Medical Pressarticlediabetic retinopathydiabetic macular edemaranibizumabbevacizumablaser therapycost-effectivenessOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 3341-3350 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic retinopathy diabetic macular edema ranibizumab bevacizumab laser therapy cost-effectiveness Ophthalmology RE1-994
spellingShingle	diabetic retinopathy diabetic macular edema ranibizumab bevacizumab laser therapy cost-effectiveness Ophthalmology RE1-994 Pramanik S Mondal LK Paine SK Jain S Chowdhury S Ganguly U Ghosh S Bose C Bhattacharjee K Bhaduri G Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population
description	Subhasish Pramanik,1 Lakshmi Kanta Mondal,2 Suman Kalyan Paine,3 Sneha Jain,2 Subhankar Chowdhury,1 Upasana Ganguly,4 Sayantan Ghosh,2 Chiranjit Bose,1 Koena Bhattacharjee,2 Gautam Bhaduri5 1Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, 700020, India; 2Regional Institute of Ophthalmology (RIO), Medical College and Hospital, Kolkata, 700073, India; 3National Institute of Biomedical Genomics (NIBMG), Kalyani, West Bengal, India; 4Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana, India; 5MGM Medical College, Kishanganj, Bihar, IndiaCorrespondence: Lakshmi Kanta MondalRegional Institute of Ophthalmology, Medical College, Kolkata, IndiaTel +91 9830830216Email Lakshmi.mondal62@gmail.comPurpose: In the present study, we aimed to evaluate the efficacy, safety, and cost-effectiveness of the anti-vascular endothelial growth factor (anti-VEGF), namely ranibizumab (RBZ) or bevacizumab (BVZ), after either focal or grid or scatter laser photocoagulation, for the treatment of diabetic macular edema (DME) in the Indian population.Methods: Retrospective data were collected in the Regional Institute of Ophthalmology, Kolkata, India between January 2018 and June 2019. Seventy-seven eyes received 3 consecutive monthly intravitreal injections of RBZ (0.5 mg) and were followed by prompt laser photocoagulation (within 7– 10 days after the third injection). Similarly, 51 eyes received 3 consecutive monthly intravitreal injections of BVZ (1.25 mg), an off-label drug, and were followed by prompt laser therapy. Safety assessments of the therapy, as well as surrogate markers of biochemical derangements related to diabetic retinopathy (DR), were also investigated at the end of 12 months.Results: Seventy-seven subjects who were given a treatment of RBZ+laser therapy showed average 6.87± 5.53 letters gain in their best-corrected visual acuity (BCVA) score, whereas the ones treated with off-label BVZ+ laser therapy demonstrated improvement in BCVA of an average 6.82± 5.76 letters in “Early Treatment Diabetic Retinopathy Study” (ETDRS) chart. The study also highlights the cost-effectiveness of both RBZ+laser and BVZ+laser therapies for the treatment of DME in DR. The results demonstrated that a subject has to pay 20.951 times more cost (in INR) for RBZ+laser therapy compared to BVZ+laser therapy, to get an almost similar outcome.Conclusion: BVZ is found to be the more attractive option for treating DME in DR for its cost-friendliness over RBZ in terms of BCVA outcome, as well as the safety perspectives, at least for the economically backward population in developing countries, like India.Keywords: diabetic retinopathy, diabetic macular edema, ranibizumab, bevacizumab, laser therapy, cost-effectiveness
format	article
author	Pramanik S Mondal LK Paine SK Jain S Chowdhury S Ganguly U Ghosh S Bose C Bhattacharjee K Bhaduri G
author_facet	Pramanik S Mondal LK Paine SK Jain S Chowdhury S Ganguly U Ghosh S Bose C Bhattacharjee K Bhaduri G
author_sort	Pramanik S
title	Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population
title_short	Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population
title_full	Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population
title_fullStr	Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population
title_full_unstemmed	Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population
title_sort	efficacy and cost-effectiveness of anti-vegf for treating diabetic retinopathy in the indian population
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/2fd35cb97e8740b79153db352c5d50d4
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Efficacy and Cost-Effectiveness of Anti-VEGF for Treating Diabetic Retinopathy in the Indian Population

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