Objective  To compare the cost and utility of aflibercept and ranibizumab in the treatment of diabetic macular edema (DME), in order to provide a reference for the selection of treatment regimens from the perspective of pharmacoeconomics.

Methods  The Markov model was established by extracting the clinical medication patterns, the survival status of the two treatment regimens within 10 years were simulated, the cost and health utilities were calculated respectively, and the incremental cost-utility ratio (ICUR) was obtained. Compared with the 2022 per capita gross domestic product (GDP) of China, which was 1 time, as the willingness to pay (WTP), the cost-utility advantage scheme was selected.

Results  During the simulation period, the ICUR of aflibercept compared with ranibizumab was 61 024.22 yuan/quality-adjusted life year (QALY), which was lower than that of WTP, which had obvious economic benefits. Univariate sensitivity analysis showed that the metastasis probability of visual acuity improvement with aflibercept and the number of ranibizumab injections per year were important influencing factors for ICUR. Probabilistic sensitivity analysis showed that when WTP was 1 time of the GDP, aflibercept had a significant cost-utility advantage, the economic probability was 63.7%, and the results were relatively stable.

Conclusion  For the treatment of DME, aflibercept has a cost-utility advantage over ranibizumab.

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