PT - JOURNAL ARTICLE AU - Aaron Y Lee AU - Thomas Butt AU - Emily Chew AU - Elvira Agron AU - Traci E Clemons AU - Catherine A Egan AU - Cecilia S Lee AU - Adnan Tufail ED - , TI - Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data AID - 10.1136/bjophthalmol-2017-310939 DP - 2018 Apr 01 TA - British Journal of Ophthalmology PG - 465--472 VI - 102 IP - 4 4099 - http://bjo.bmj.com/content/102/4/465.short 4100 - http://bjo.bmj.com/content/102/4/465.full SO - Br J Ophthalmol2018 Apr 01; 102 AB - Aims To evaluate the cost-effectiveness of Age-Related Eye Disease Study (AREDS) 1 & 2 supplements in patients with either bilateral intermediate age-related macular degeneration, AREDS category 3, or unilateral neovascular age-related macular degeneration AMD (nAMD), AREDS category 4.Methods A patient-level health state transition model based on levels of visual acuity in the better-seeing eye was constructed to simulate the costs and consequences of patients taking AREDS vitamin supplements. Setting: UK National Health Service (NHS). The model was populated with data from AREDS and real-world outcomes and resource use from a prospective multicentre national nAMD database study containing 92 976 ranibizumab treatment episodes.Interventions Two treatment approaches were compared: immediate intervention with AREDS supplements or no supplements. Main outcome measures: quality-adjusted life years (QALYs) and healthcare costs were accrued for each strategy, and incremental costs and QALYs were calculated for the lifetime of the patient. One-way and probabilistic sensitivity analyses were employed to test the uncertainty of the model.Results For AREDS category 3, the incremental cost-effectiveness ratio was £30 197. For AREDS category 4 compared with no intervention, AREDS supplements are more effective (10.59 vs 10.43 QALYs) and less costly (£52 074 vs 54 900) over the lifetime of the patient.Conclusions The recommendation to publicly fund AREDS supplements to category 3 patients would depend on the healthcare system willingness to pay. In contrast, initiating AREDS supplements in AREDS category 4 patients is both cost saving and more effective than no supplement use and should therefore be considered in public health policy.