[Brolucizumab in neovascular age-related macular degeneration]

Luxardo R, Bardach A, Alfie V, Argento F, Ciapponi A, García Martí S, Pichon-Riviere A, Alcaraz A, Augustovski F
Record ID 32018002324
Original Title: Brolucizumab en degeneración macular neo vascular asociada a la edad
Authors' recommendations: Moderate-quality evidence suggests that brolucizumab has a significant benefit in patients with neovascular age-related macular degeneration in improving visual acuity and anatomical changes (reduction of macular thickness and choroidal neovascularization), similarly to ranibizumab or aflibercept. Regarding safety, evidence suggests that brolucizumab has a higher rate of non-ocular (arterial thrombosis) and ocular (endophthalmitis) serious adverse events, although they were rare and not significant when compared with ranibizumab and aflibercept. Moderate-quality evidence suggests that brolucizumab is less efficacious than dose- fractioned/off-label bevacizumab in patients with neovascular age-related macular degeneration, in view of its significantly higher rate of non-ocular serious adverse events (arterial thrombosis), although they were rare. Most clinical practice guidelines identified about this condition were published before brolucizumab obtained its authorization from the main European and Latin American health insurances to become commercially available. Public health agencies from Canada, United Kingdom and some United States private institutions cover this technology. Some European health technology and economic assessments (Germany and EUnetHTA) showed that brolucizumab was not cost-effective because its added benefit could not be demonstrated vs. its comparators. The Canadian agency on health technology assessments considered its price should significantly be reduced if fractioned/off-label bevacizumab were to become a therapeutic alternative. The Latin American health sponsors surveyed do not mention this technology. There are no economic assessments studying the impact of this drug in Argentina, however, in view of the frequent use of fractioned/off-label bevacizumab, it is necessary to take into account that the cost of brolucizumab would be considerably higher.
Project Status: Completed
Year Published: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Macular Degeneration
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Intravitreal Injections
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.