Cost‑effectiveness of anti‑oxidant vitamins plus zinc treatment to prevent the progression of intermediate age‑related macular degeneration. A Singapore perspective.

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dc.contributor.authorSaxena, Nakul
dc.contributor.authorGeorge, Pradeep Paul
dc.contributor.authorHeng, Bee Hoon
dc.contributor.authorLim, Tock Han
dc.contributor.authorYong, Shao Onn
dc.date.accessioned2016-01-13T06:04:45Z
dc.date.available2016-01-13T06:04:45Z
dc.date.issued2015-06
dc.description.abstractPurpose: To determine if providing high dose anti‑oxidant vitamins and zinc treatment age‑related eye disease study (AREDS formulation) to patients with intermediate age‑related macular degeneration (AMD) aged 40–79 years from Singapore is cost‑effective in preventing progression to wet AMD. Methods: A hypothetical cohort of category 3 and 4 AMD patients from Singapore was followed for 5 calendar years to determine the number of patients who would progress to wet AMD given the following treatment scenarios: (a) AREDS formulation or placebo followed by ranibizumab (as needed) for wet AMD. (b) AREDS formulation or placebo followed by bevacizumab (monthly) for wet AMD. (c) AREDS formulation or placebo followed by aflibercept (VIEW I and II trial treatment regimen). Costs were estimated for the above scenarios from the providers’ perspective, and cost‑effectiveness was measured by cost per disability‑adjusted life year (DALY) averted with a disability weight of 0.22 for wet AMD. The costs were discounted at an annual rate of 3%. Results: Over 5400 patients could be prevented from progressing to wet AMD cumulatively if AREDS formulation were prescribed. AREDS formulation followed by ranibizumab was cost‑effective compared to placebo‑ranibizumab or placebo‑aflibercept combinations (cost per DALY averted: SGD$23,662.3 and SGD$21,138.8, respectively). However, bevacizumab (monthly injections) alone was more cost‑effective compared to AREDS formulation followed by bevacizumab. Conclusion: Prophylactic treatment with AREDS formulation for intermediate AMD patients followed by ranibizumab or for patients who progressed to wet AMD was found to be cost‑effective. These findings have implications for intermediate AMD screening, treatment and healthcare planning in Singapore.en_US
dc.identifier.citationSaxena Nakul, George Pradeep Paul, Heng Bee Hoon, Lim Tock Han, Yong Shao Onn. Cost‑effectiveness of anti‑oxidant vitamins plus zinc treatment to prevent the progression of intermediate age‑related macular degeneration. A Singapore perspective. Indian Journal of Ophthalmology. 2015 June; 63(6): 516-523.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/170389
dc.language.isoenen_US
dc.source.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550985/en_US
dc.subjectAge‑related macular degenerationen_US
dc.subjectanti‑oxidant vitaminsen_US
dc.subjectcost‑effectiveness analysisen_US
dc.subjectSingaporeen_US
dc.titleCost‑effectiveness of anti‑oxidant vitamins plus zinc treatment to prevent the progression of intermediate age‑related macular degeneration. A Singapore perspective.en_US
dc.typeArticleen_US
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