---
title: "4D-150 in Neovascular age-related macular degeneration: cost-effectiveness analyses and utility weights"
description: "Published cost-effectiveness analyses and health-state utility weights for 4D-150 in Neovascular age-related macular degeneration, each value quoted from the article: 11 cost-effectiveness analyses and 7 studies reporting utility weights. Analyses: Bevacizumab, ranibizumab, and aflibercept versus no treatment in neovascular age-related macular degeneration, United States: Brown et al. (2020); Aflibercept 2 mg every 8 weeks versus monthly and as-needed ranibizumab in wet age-related macular degeneration, United States: Hernandez et al. (2018); Brolucizumab versus aflibercept and ranibizumab in wet age-related macular degeneration, United States: Yu et al. (2021); Ranibizumab port delivery system versus intravitreal ranibizumab injections in neovascular age-related macular degeneration, United States: Brown et al. (2024); 7 further articles. Utility weights: Utility weights by visual acuity, neovascular age-related macular degeneration: Brown et al. (2024); Utility weights by best-corrected visual acuity in the better-seeing eye, wet age-related macular degeneration: Hernandez et al. (2018); Utility weights by best-corrected visual acuity, neovascular age-related macular degeneration: Stein et al. (2014); Utility weights by best-corrected visual acuity and for long-term adverse events, neovascular age-related macular degeneration: Stein et al. (2013); 3 further articles. Every value is a verbatim quote from the primary article it is shown with."
canonical: "https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/cost-effectiveness-analyses"
published: "2026-10-22T07:49:06-04:00"
modified: "2026-10-22T07:49:06-04:00"
---

# 4D-150 in Neovascular age-related macular degeneration: cost-effectiveness analyses and utility weights

Published cost-effectiveness analyses and health-state utility weights that a model of this product could cite, adapt, or compare against, grouped by how each article relates to the product and its indication. Every value is quoted from the article it cites, and section 3 lists the searches that found the articles.

<a id="cost-effectiveness-analyses-overview"></a>

## Overview

<a id="cost-effectiveness-analyses-topic-overview-1"></a>

| Item | Detail |
| --- | --- |
| Literature searched | Tufts Medical Center Cost-Effectiveness Analysis Registry, searched October 21, 2026; the queries are listed in section 3. |
| Cost-effectiveness analyses | 11 |
| Studies reporting utility weights | 7 |

<a id="cost-effectiveness-analyses-cost-effectiveness-analyses"></a>

## 1 Cost-effectiveness analyses

<a id="cost-effectiveness-analyses-heading-1.1"></a>

### 1.1 Analyses of 4D-150

No evidence found.

<a id="cost-effectiveness-analyses-heading-1.2"></a>

### 1.2 Treatments for the same indication

<a id="cost-effectiveness-analyses-topic-1.2-1"></a>

#### Bevacizumab, ranibizumab, and aflibercept versus no treatment in neovascular age-related macular degeneration, United States: Brown et al. (2020)

Relevance: Compares intravitreal bevacizumab, ranibizumab, and aflibercept with observation in neovascular age-related macular degeneration in the United States, including aflibercept, the active comparator in the 4FRONT-1 trial.

> “To perform 11- and 2-year health care sector (ophthalmic) and societal cost perspective reference case, cost-utility analyses comparing bevacizumab, ranibizumab, and aflibercept monotherapies for neovascular age-related macular degeneration (NVAMD).”
> “We employed patient utilities, bilateral outcomes, 2018 U.S. dollars, vision-related mortality, a Medicare fee schedule, and CATT (Comparison of Age-Related Macular Degeneration Treatments) study and VIEW (VEGF Trap-Eye: Investigation of Efficacy and Safety in Wet AMD) trial.”
> “A combined-eye model cost basis was used.”
> “a 3% annual discount rate for QALY outcomes and costs”
> “Bevacizumab and ranibizumab each conferred an 11-year, 1.339 QALY gain versus observation. Aflibercept conferred a 1.380 QALY gain.”
> “The average ophthalmic cost perspective CUR for bevacizumab was $11,033/QALY, $79,600/QALY for ranibizumab, and $44,801/QALY for aflibercept.”
> “Aflibercept conferred greater QALY gain for less cost than ranibizumab but was not cost-effective compared to bevacizumab ($1,151,451/QALY incremental CUR).”
> “The 11-year model ophthalmic cost perspective and societal cost perspective, incremental CURs comparing aflibercept to bevacizumab were both $1,147,273/QALY (Table 7)”
> “Aflibercept was more effective than ranibizumab because it provided greater patient value gain (QALY gain) for less cost than ranibizumab”
> “Two-year therapy prevented a 1-month-of-life loss, and revealed bevacizumab, ranibizumab, and aflibercept conferred 0.141, 0.141, and 0.164 QALY gains, respectively, with corresponding average CURs of $40,371/QALY, $335,726/QALY, and $168,006/QALY, respectively.”

Source: [Brown et al. (2020)](https://pubmed.ncbi.nlm.nih.gov/32565050/)

<a id="cost-effectiveness-analyses-topic-1.2-2"></a>

#### Aflibercept 2 mg every 8 weeks versus monthly and as-needed ranibizumab in wet age-related macular degeneration, United States: Hernandez et al. (2018)

Relevance: Compares the aflibercept regimen of the 4FRONT-1 comparator arm with monthly and as-needed ranibizumab over a lifetime horizon from a U.S. payer perspective.

> “To assess the cost-effectiveness of intravitreal aflibercept injection 2 mg every 8 weeks after 3 initial monthly doses (IAI 2q8) versus ranibizumab 0.5 mg monthly (Rq4) and pro re nata (PRN) in the treatment of patients with wAMD from a U.S. payer perspective.”
> “A Markov cohort model was developed to estimate the lifetime quality-adjusted life-years (QALYs) and costs of treating patients with wAMD with IAI 2q8, Rq4, and ranibizumab PRN.”
> “Utilities and costs (in 2016 U.S. dollars) were from published literature. Health outcomes and costs were discounted at an annual rate of 3%.”
> “Over a lifetime, IAI 2q8 provided equal health benefits with Rq4 (5.44 QALYs) at a lower total cost ($33,745 vs. $48,031) as a result of fewer injections.”
> “IAI 2q8 yielded greater QALYs compared with ranibizumab PRN (5.440 vs. 5.404) at a higher cost ($33,745 vs. $33,652), with an incremental cost per QALY gained of $2,583 (i.e., IAI 2q8 was cost-effective vs. ranibizumab PRN).”
> “A treatment was deemed cost-effective at ICERs below a willingness-to-pay (WTP) threshold of $50,000 per QALY gained.”
> “The PSA results indicate that compared with Rq4, IAI 2q8 was cost-effective in all simulations, being dominant in 46% of them. Compared with ranibizumab PRN, IAI 2q8 was cost-effective in 98% of all simulations”

Source: [Hernandez et al. (2018)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10397814/)

<a id="cost-effectiveness-analyses-topic-1.2-3"></a>

#### Brolucizumab versus aflibercept and ranibizumab in wet age-related macular degeneration, United States: Yu et al. (2021)

Relevance: Compares brolucizumab with aflibercept, the active comparator in the 4FRONT-1 trial, and with ranibizumab over a lifetime horizon from a U.S. health care payer perspective.

> “A Markov model was developed in Microsoft Excel to model the treatment of wet AMD patients with brolucizumab compared with aflibercept and ranibizumab over a lifetime time horizon (base case) and 5-year time horizon (scenario analysis) from a US payer perspective.”
> “The Markov model consisted of 3 primary health states: on treatment, off treatment, and death.”
> “In the base case, outcomes and costs were discounted at a rate of 3% annually.”
> “In the base case, brolucizumab was less costly than aflibercept ($63,614 vs $72,189), and brolucizumab generated 0.0079 more quality-adjusted life-years (QALYs) than aflibercept (4.580 vs 4.572).”
> “Since brolucizumab was less costly and more effective than aflibercept, an ICER value was not calculated, as brolucizumab was a dominant treatment over aflibercept.”
> “Additionally, brolucizumab was less costly than ranibizumab ($63,614 vs $128,163) and generated 0.0078 more QALYs than ranibizumab (4.580 vs 4.572) in the base case.”
> “Since brolucizumab was less costly and more effective than ranibizumab, an ICER value was not calculated, as brolucizumab was a dominant treatment over ranibizumab.”

Source: [Yu et al. (2021)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10390922/)

<a id="cost-effectiveness-analyses-topic-1.2-4"></a>

#### Ranibizumab port delivery system versus intravitreal ranibizumab injections in neovascular age-related macular degeneration, United States: Brown et al. (2024)

Relevance: Evaluates the ranibizumab port delivery system, a treatment listed in section 2, against intravitreal ranibizumab injections from U.S. direct medical and societal cost perspectives.

> “To quantify the cost-utility ratio of the ranibizumab Port Delivery System (PDS; SUSVIMO) versus intravitreal ranibizumab injections for treating neovascular age-related macular degeneration (nAMD) based upon Archway Phase 3 Trial data.”
> “Ophthalmic patient, time tradeoff utilities, direct medical and societal cost perspectives, 12-year, 1-year, and 5-year timelines, United States 2022 real dollars, and a 3% annual discount rate were employed.”
> “Versus no therapy, the 1-year PDS QALY gain was 0.0156 (6.8%) versus 0.0063 (0.82%) for intravitreal injections (P < 0.001), whereas the respective 12-year QALY gains were 1.714 (28%) and 1.639 (26.8%) (P = 0.99).”
> “The 1-year incremental PDS $/QALY versus injections was cost effective at $75 497/QALY.”
> “Five-year PDS therapy was not incrementally cost effective at $304 108/QALY, nor was the 12-year therapy at $761 646/QALY.”
> “Average 12-year cost-utility ratios were $78 773/QALY for the PDS and $47 917/QALY for injection therapy.”
> “Adding -$476 442 12-year offsetting societal costs netted $314 521 to society per PDS participant versus $370 958 per participant for injection therapy.”

Source: [Brown et al. (2024)](https://pubmed.ncbi.nlm.nih.gov/37981235/)

<a id="cost-effectiveness-analyses-topic-1.2-5"></a>

#### Monthly and as-needed bevacizumab and ranibizumab in newly diagnosed neovascular age-related macular degeneration, United States: Stein et al. (2014)

Relevance: Compares monthly and as-needed bevacizumab and ranibizumab, anti-VEGF therapies listed in section 2, in newly diagnosed neovascular age-related macular degeneration in the United States from a societal perspective.

> “We developed a Markov model to capture the total costs and HRQL for patients with newly diagnosed neovascular AMD under four treatment options: monthly bevacizumab injections, as-needed bevacizumab injections, monthly ranibizumab injections, and as-needed ranibizumab injections.”
> “A societal perspective was taken to encompass all parties affected by the treatment choice: patients, providers, and payers.”
> “The model followed a hypothetical cohort of patients aged 80 years (the mean age for neovascular AMD onset) with neovascular AMD (as defined in CATT) over a 20-year time horizon.”
> “All costs are in 2012 U.S. dollars. Costs and health utilities were discounted at 3% annually.”
> “Over 20 years, the expected costs for a single patient with newly diagnosed neovascular AMD receiving monthly bevacizumab, as-needed bevacizumab, monthly ranibizumab, and as-needed ranibizumab were $79 771, $65 267, $257 496, and $163 694, and the QALYs for a patient receiving these treatments were 6.66, 6.60, 6.68, and 6.64, respectively.”
> “The ICER of monthly bevacizumab over as-needed bevacizumab was $242 357/QALY. The ICER of monthly ranibizumab over as-needed bevacizumab was $10 708 377/QALY. As-needed ranibizumab was dominated by monthly bevacizumab because monthly bevacizumab had lower costs and higher QALYs”

Source: [Stein et al. (2014)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4109727/)

<a id="cost-effectiveness-analyses-topic-1.2-6"></a>

#### Faricimab versus ranibizumab, aflibercept, brolucizumab, and best supportive care in neovascular age-related macular degeneration and diabetic macular edema, Japan: Yanagi et al. (2025)

Relevance: Evaluates faricimab, a bispecific anti-VEGF and angiopoietin-2 antibody listed in section 2, against ranibizumab, aflibercept, brolucizumab, and best supportive care in Japan, with the ratios shown limited to those for neovascular age-related macular degeneration.

> “A Markov model for cost-effectiveness analysis of anti-VEGF treatment in patients with nAMD and DME was applied based on cost and utility value data from Japan.”
> “Faricimab administered through a treat-and-extend (T&E) regimen was compared with ranibizumab administered pro re nata (PRN) and T&E, aflibercept T&E, brolucizumab T&E, and best supportive care (BSC).”
> “Further to treatment costs (public payer perspective), the societal burden (societal perspective), including costs of travel, informal care, and productivity, was assessed.”
> “In treatment of nAMD, lifetime quality-adjusted life years (QALYs) gained were highest with faricimab (faricimab T&E: 6.92, ranibizumab PRN: 6.88, ranibizumab T&E: 6.91, aflibercept T&E: 6.89, brolucizumab T&E: 6.89, BSC: 5.99).”
> “From the public payer perspective, the lifetime total cost for faricimab T&E was lower than those for ranibizumab (PRN, T&E) and brolucizumab (T&E), comparable to aflibercept T&E, and higher than BSC (incremental costs: 158,385 and 6,475,511 JPY, respectively).”
> “As a result, faricimab was cost-effective or dominant in the treatment of nAMD, excluding BSC.”
> “From the societal perspective, faricimab was dominant against all comparators in nAMD.”

Source: [Yanagi et al. (2025)](https://pubmed.ncbi.nlm.nih.gov/40078048/)

<a id="cost-effectiveness-analyses-topic-1.2-7"></a>

#### Brolucizumab versus aflibercept in neovascular age-related macular degeneration, Italy: Ferrante et al. (2022)

Relevance: Compares brolucizumab with aflibercept, the active comparator in the 4FRONT-1 trial, over a lifetime horizon from an Italian health care sector perspective.

> “The simulation of costs and outcomes was carried out using a Markov model over a time horizon of 15 years.”
> “patients with a mean age of 75.8 years at the beginning of the model are observed over a time horizon of 15 years (equivalent to a lifetime horizon, given age at beginning of simulation). A discount rate of 3.0% was applied to costs and outcomes.”
> “The Italian National Healthcare Service (NHS) perspective was considered, therefore only healthcare direct costs (treatment acquisition, administration, adverse events, disease monitoring) were analysed.”
> “In the base-case analysis, brolucizumab was dominant over aflibercept (+ 0.11 years QALY gained and -€15,679 costs).”
> “The results of the probabilistic sensitivity analysis showed that when the willingness to pay is equal to €50,000 per QALY gained, brolucizumab would be dominant in 84% of simulations and in the remaining simulations brolucizumab would be cost-effective compared to aflibercept.”

Source: [Ferrante et al. (2022)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9052557/)

<a id="cost-effectiveness-analyses-topic-1.2-8"></a>

#### Aflibercept versus bevacizumab and ranibizumab in wet age-related macular degeneration, Finland: Vottonen and Kankaanpää (2016)

Relevance: Compares aflibercept, the active comparator in the 4FRONT-1 trial, with monthly bevacizumab and with ranibizumab in a model of both eyes in wet age-related macular degeneration from the perspective of a Finnish university hospital.

Access: Not open access

Not quoted: The results are reported in the full text, which is closed access.

> “In this study, we wanted to evaluate whether less frequent injections of aflibercept would make it more cost-effective when compared with ranibizumab and low priced bevacizumab.”
> “We used a two-eye model to simulate the progression and the treatment of the disease. We selected an 8-year period, 3-month cycles and five health states based on the visual acuity of the better-seeing eye.”
> “We conducted the analysis from the hospital perspective and we used the health care costs obtained from Kuopio University Hospital.”
> “The incremental cost-effectiveness ratio (ICER) with 3% discount rate (€/QALY) for aflibercept compared with monthly bevacizumab was 1 801 228 and when compared with ranibizumab given as needed, the ICER was minus 3 716 943.”
> “Monthly injected bevacizumab was the most cost-effective treatment and monthly ranibizumab the least effective.”

Source: [Vottonen and Kankaanpää (2016)](https://pubmed.ncbi.nlm.nih.gov/27481048/)

<a id="cost-effectiveness-analyses-heading-1.3"></a>

### 1.3 The same disease in other populations or settings

No evidence found.

<a id="cost-effectiveness-analyses-heading-1.4"></a>

### 1.4 Related diseases and analogous treatments

<a id="cost-effectiveness-analyses-topic-1.4-1"></a>

#### Voretigene neparvovec versus standard of care in biallelic RPE65-mediated retinal disease, United States: ICER final evidence report (2018)

Relevance: Evaluates voretigene neparvovec, a one-time subretinal AAV gene therapy for RPE65-mediated retinal disease, against standard of care from U.S. health care system and modified societal perspectives, an analogue for pricing a one-time intravitreal AAV gene therapy such as 4D-150.

> “We developed a de novo Markov model with two general health states”
> “Therefore, we also included an analysis using a modified societal perspective which included direct medical costs as well as indirect costs for education and productivity loss, and direct non-medical costs for informal care, transportation, and nursing home care.”
> “We used a 3% discount rate for costs and health outcomes. The model used one-year cycles over a lifetime time horizon.”
> “All costs were adjusted to 2017 US dollars.”
> “In the population receiving VN at age 15, the average total lifetime cost for individuals treated with VN was approximately $1,039,000 from a US health care system perspective.”
> “Voretigene neparvovec provided an additional 1.3 QALYs over the remaining lifetime of an individual, leading to an incremental cost-effectiveness ratio of approximately $644,000 per additional QALY gained from the US health care system perspective, and $480,000 per additional QALY gained from the modified societal perspective.”
> “In the population receiving VN at age 3, the average total lifetime cost for individuals treated with VN was approximately $962,000 from a US health care system perspective.”
> “Voretigene neparvovec provided an additional 2.7 QALYs over the remaining lifetime of an individual, leading to an incremental cost-effectiveness ratio of approximately $288,000 per additional QALY gained from the US health care system perspective, and $135,000 per additional QALY gained from the modified societal perspective.”

Source: [ICER final evidence report (2018)](https://icer.org/wp-content/uploads/2020/10/MWCEPAC_VORETIGENE_EVIDENCE_REPORT_01122018-1.pdf)

<a id="cost-effectiveness-analyses-topic-1.4-2"></a>

#### Voretigene neparvovec versus standard of care in biallelic RPE65-mediated inherited retinal disease, United States: Zimmermann et al. (2019)

Relevance: Evaluates voretigene neparvovec, a one-time ocular AAV gene therapy, against standard of care over a lifetime horizon from U.S. healthcare system and modified societal perspectives.

> “We modeled the cost-utility of VN compared with standard of care (SoC).”
> “A 2-state Markov model, alive and dead, with a lifetime horizon.”
> “VN led to an improvement in VA and VF that we assumed was maintained for 10 years followed by a 10-year waning period.”
> “The cost of VN was $850 000, and other direct medical costs for depression and trauma were included for a US healthcare system perspective. A modified societal perspective also included direct nonmedical costs and indirect costs.”
> “VN provided an additional 1.3 QALYs over the remaining lifetime of an individual.”
> “The average total lifetime direct medical cost for individuals treated with VN was $1 039 000 compared with $213 400 for SoC, leading to an incremental cost-effectiveness ratio (ICER) of $643 800/QALY from the US healthcare system perspective.”
> “Direct nonmedical costs totalled $1 070 900 for VN and $1 203 300 for SoC, and indirect costs totalled $405 400 for VN and $482 900 for SoC, leading to an ICER of $480 100/QALY from the modified societal perspective.”

Source: [Zimmermann et al. (2019)](https://pubmed.ncbi.nlm.nih.gov/30711060/)

<a id="cost-effectiveness-analyses-topic-1.4-3"></a>

#### Voretigene neparvovec-rzyl versus standard care in RPE65-mediated inherited retinal disease, United States: Johnson et al. (2019)

Relevance: Evaluates voretigene neparvovec-rzyl, a one-time ocular AAV gene therapy, against standard care over a lifetime horizon in the United States.

> “In this economic analysis, a health state transition model based on visual acuity and field with a lifetime horizon was developed to estimate the cost-effectiveness of voretigene neparvovec-rzyl.”
> “Indirect costs, including educational attainment, productivity, caregiver burden, and governmental programs, were estimated using published literature and data analysis of public national surveys.”
> “Costs and benefits were discounted at 3.0% annually.”
> “The model population included 70 patients with RPE65 -mediated IRD, with a mean age of 15 years; 42 of 70 patients (60%) were female.”
> “Voretigene neparvovec-rzyl had higher QALYs (18.1 vs 8.6) and lower total lifetime costs ($2.2 million vs $2.8 million) than SC (ie, was dominant) when including indirect costs, resulting in cost-savings and QALY increases. When indirect costs were excluded, the cost per QALY was $79 618.”
> “Voretigene neparvovec-rzyl remains cost-effective if at least 8.8% of the long-term treatment effect continues after year 3 when including indirect costs and 43.3% when excluding indirect costs, assuming a cost threshold of $150 000 per quality-adjusted life-year.”

Source: [Johnson et al. (2019)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6646972/)

<a id="cost-effectiveness-analyses-utility-weights"></a>

## 2 Utility weights

<a id="cost-effectiveness-analyses-heading-2.1"></a>

### 2.1 Utility weights from analyses of 4D-150

No evidence found.

<a id="cost-effectiveness-analyses-heading-2.2"></a>

### 2.2 Utility weights for the same indication

<a id="cost-effectiveness-analyses-topic-2.2-1"></a>

#### Utility weights by visual acuity, neovascular age-related macular degeneration: Brown et al. (2024)

Relevance: Ophthalmic patient time tradeoff utilities, adjusted for neovascular conversion in fellow eyes, used in a U.S. model of the ranibizumab port delivery system in neovascular age-related macular degeneration.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

> “Ophthalmic patient, time tradeoff utilities, direct medical and societal cost perspectives, 12-year, 1-year, and 5-year timelines, United States 2022 real dollars, and a 3% annual discount rate were employed.”
> “Utilities were adjusted for nAMD conversion in fellow eyes during the 12-year, mean participant life expectancy.”

Source: [Brown et al. (2024)](https://pubmed.ncbi.nlm.nih.gov/37981235/)

<a id="cost-effectiveness-analyses-topic-2.2-2"></a>

#### Utility weights by best-corrected visual acuity in the better-seeing eye, wet age-related macular degeneration: Hernandez et al. (2018)

Relevance: Utilities by best-corrected visual acuity letter score in the better-seeing eye used in a U.S. model of wet age-related macular degeneration.

> “Utilities were assigned based on the BCVA of the BSE.”

Source: [Hernandez et al. (2018)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10397814/)

| Health state | Utility |
| --- | --- |
| “< 35” | “0.610 (0.57-0.65)” |
| “35-49” | “0.665 (0.62-0.71)” |
| “50-64” | “0.720 (0.67-0.77)” |
| “65-79” | “0.810 (0.78-0.84)” |
| “> 79” | “0.880 (0.85-0.91)” |

Source: [Hernandez et al. (2018)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10397814/)

<a id="cost-effectiveness-analyses-topic-2.2-3"></a>

#### Utility weights by best-corrected visual acuity, neovascular age-related macular degeneration: Stein et al. (2014)

Relevance: Utilities by visual acuity range used in a U.S. model of newly diagnosed neovascular age-related macular degeneration.

> “We incorporated utility scores for each BCVA level as captured by Brown and colleagues”

Source: [Stein et al. (2014)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4109727/)

| Health state | Utility |
| --- | --- |
| “20/12–20/20” | “0.92” |
| “20/25–20/40” | “0.84” |
| “20/50–20/80” | “0.76” |
| “20/100–20/160” | “0.66” |
| “≤ 20/200” | “0.61” |

Source: [Stein et al. (2014)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4109727/)

<a id="cost-effectiveness-analyses-topic-2.2-4"></a>

#### Utility weights by best-corrected visual acuity and for long-term adverse events, neovascular age-related macular degeneration: Stein et al. (2013)

Relevance: Utilities by best-corrected visual acuity range, blindness from endophthalmitis, stroke, and myocardial infarction used in a U.S. model of anti-VEGF treatment for neovascular age-related macular degeneration.

> “We incorporated utility scores for each level of BCVA as captured by Brown and colleagues”

Source: [Stein et al. (2013)](https://pmc.ncbi.nlm.nih.gov/articles/PMC3797829/)

| Health state | Utility |
| --- | --- |
| “20/12–20/20” | “0.92” |
| “20/25–20/40” | “0.84” |
| “20/50–20/80” | “0.76” |
| “20/100–20/160” | “0.66” |
| “≤20/200” | “0.61” |
| “Blindness from endophthalmitis” | “0.37” |
| “CVA” | “0.39” |
| “MI” | “0.84” |

Source: [Stein et al. (2013)](https://pmc.ncbi.nlm.nih.gov/articles/PMC3797829/)

<a id="cost-effectiveness-analyses-topic-2.2-5"></a>

#### Utility weights for two-eye health states by visual acuity of the better-seeing eye, wet age-related macular degeneration: Vottonen and Kankaanpää (2016)

Relevance: Utilities for health states defined by the visual acuity of the better-seeing eye in a model of both eyes in wet age-related macular degeneration.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

> “We selected an 8-year period, 3-month cycles and five health states based on the visual acuity of the better-seeing eye.”
> “The transition probabilities and utilities attached to the health states were gathered from previous studies.”

Source: [Vottonen and Kankaanpää (2016)](https://pubmed.ncbi.nlm.nih.gov/27481048/)

<a id="cost-effectiveness-analyses-topic-2.2-6"></a>

#### Disutilities for adverse events of intravitreal treatment, neovascular age-related macular degeneration: Ferrante et al. (2022)

Relevance: Disutilities for cataract, endophthalmitis, intraocular inflammation, and retinal detachment as adverse events of intravitreal anti-VEGF treatment in neovascular age-related macular degeneration; intraocular inflammation is reported for 4D-150 in the PRISM trial.

> “This effect was quantified through a temporary disutility (the coefficient is subtracted from the utility of the state of health).”
> “Each AE-related disutility was applied for a certain duration.”

Source: [Ferrante et al. (2022)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9052557/)

| Health state | Utility |
| --- | --- |
| “Cataract” | “−0.142” |
| “Endophthalmitis” | “−0.3” |
| “Intraocular inflammation” | “−0.044” |
| “Detachment of the retina” | “−0.27” |

Source: [Ferrante et al. (2022)](https://pmc.ncbi.nlm.nih.gov/articles/PMC9052557/)

<a id="cost-effectiveness-analyses-topic-2.2-7"></a>

#### Utility weights for blindness and no vision impairment, wet age-related macular degeneration: Yu et al. (2021)

Relevance: Utilities for blindness and for no vision impairment and a disutility for best-corrected visual acuity substates of the treated eye in a U.S. model of neovascular age-related macular degeneration.

> “Utility inputs for each BCVA-linked Markov state were derived from Brown et al,47 which used a time trade-off methodology in order to derive utility values for each state.”
> “Utilities ranged from 0.78 to 0.88 for blindness and no vision impairment, respectively.”
> “A utility decrement of 0.1 was assumed between the best and worst BCVA substates for the treated eye.”

Source: [Yu et al. (2021)](https://pmc.ncbi.nlm.nih.gov/articles/PMC10390922/)

<a id="cost-effectiveness-analyses-heading-2.3"></a>

### 2.3 Utility weights for the same disease in other populations or settings

No evidence found.

<a id="cost-effectiveness-analyses-heading-2.4"></a>

### 2.4 Utility weights for related diseases and analogous treatments

No evidence found.

<a id="cost-effectiveness-analyses-search-strategy"></a>

## 3 Search strategy

<a id="cost-effectiveness-analyses-topic-3-1"></a>

| Dataset | Query | Results |
| --- | --- | --- |
| Ratios | "macular degeneration" | 198 |
| Ratios | "neovascular" OR "wet AMD" OR "choroidal neovascularization" | 140 |
| Ratios | aflibercept | 134 |
| Ratios | faricimab | 31 |
| Ratios | ranibizumab | 221 |
| Ratios | bevacizumab AND ("macular" OR "intravitreal") | 116 |
| Ratios | brolucizumab | 32 |
| Ratios | voretigene OR "inherited retinal" | 11 |
| Ratios | "gene therapy" AND ("retinal" OR "ocular" OR "eye") | 5 |
| Ratios | fluocinolone OR "dexamethasone implant" OR "dexamethasone intravitreal" OR Ozurdex OR Iluvien | 10 |
| Ratios | "port delivery" | 3 |
| Ratios | pegaptanib OR verteporfin | 61 |
| Ratios | biosimilar AND (ranibizumab OR bevacizumab OR aflibercept) | 50 |
| Methods | "4D-150" OR "4DMT" | 0 |
| Weights | "macular degeneration" | 297 |
| Weights | "neovascular" OR "wet AMD" OR "nAMD" | 174 |
| Weights | endophthalmitis OR "intraocular inflammation" OR "retinal detachment" | 50 |
| Weights | "intravitreal injection" OR "injection burden" | 31 |
| Ratios | "sustained release" OR "sustained-release" OR "intravitreal implant" OR "drug delivery" | 56 |

## Related pages
- [4D-150: Neovascular age-related macular degeneration](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration.md)
- [4D-150 in Neovascular age-related macular degeneration: Terms and abbreviations](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/terms-and-abbreviations) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/terms-and-abbreviations.md)
- [4D-150: Neovascular age-related macular degeneration](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/executive-summary) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/executive-summary.md)
- [4D-150 in Neovascular age-related macular degeneration: Product information and disease description](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/product-information-and-disease-description) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/product-information-and-disease-description.md)
- [4D-150 in Neovascular age-related macular degeneration: Clinical evidence](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/clinical-evidence) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/clinical-evidence.md)
- [4D-150 in Neovascular age-related macular degeneration: Economic information and modeling report](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/economics) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/economics.md)
- [4D-150 in Neovascular age-related macular degeneration: References](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/references) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/references.md)
- [4D-150 in Neovascular age-related macular degeneration: prevalence by geography](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/prevalence) · [Markdown](https://www.evicenter.com/drugs/4d-150--neovascular-age-related-macular-degeneration/prevalence.md)
