CADTH undertook reanalyses to address limitations that included bevacizumab as a relevant comparator, applying equal treatment discontinuation, adjusting vision impairment costs, and applying a pooled, long-term treatment effect.

Using the CADTH base-case reanalyses, brolucizumab would not be considered cost-effective treatment at a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life-year (QALY). The probability of brolucizumab being considered the most cost-effective intervention was 0% at a threshold of $50,000 per QALY (and even at a threshold of $100,000 per QALY). Price reductions can improve the cost-effectiveness of brolucizumab in patients with neovascular age-related macular degeneration (nAMD). At a WTP threshold of $50,000 per QALY, a respective price reduction of 85% is required for brolucizumab to be considered cost-effective compared to bevacizumab. No price reduction would be required for brolucizumab if bevacizumab was unavailable as a treatment option.

While some uncertainties remain in the model, it is highly unlikely that brolucizumab would be considered a cost-effective intervention relative to bevacizumab based on the efficacy estimates and price submitted by the sponsor.

Contents

• Abbreviations
• Executive Summary
  • Conclusions
• Stakeholder Input Relevant to the Economic Review
• Economic Review
  • Economic Evaluation
  • Issues for Consideration
  • Overall Conclusions
• Appendix 1. Cost Comparison Table
• Appendix 2. Submission Quality
• Appendix 3. Detailed Information on the Submitted Economic Evaluation
• Appendix 4. CADTH Detailed Reanalyses and Sensitivity Analyses of the Economic Evaluation
• References

Version: Final

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