Table 2. Specification of the model parameters.
Model parameter | Value | Data source | |
Mortality | Overall death rate: 5.63/1000; age- and gender-specific rates used | Australian Bureau of Statistics[16], [17] | |
Patients with health insurance/access problems | All residents of Australia are covered under Medicare plan and ranibizumab is fully covered for subfoveal neovascular AMD | Australian Health Servicea | |
1-year incidence (SE) of neovascular AMD, women by age, years | < 60 | 0 | BMES[13] |
60–69 | 0.0027 (0.0008) | ||
70–79 | 0.0064 (0.0016) | ||
≥ 80 | 0.0155 (0.0093) | ||
1-year incidence (SE) of neovascular AMD, men by age, years | < 60 | 0 | BMES[13] |
60–69 | 0.0011 (0.0006) | ||
70–79 | 0.0023 (0.0010) | ||
≥ 80 | 0.0083 (0.0080) | ||
Patients with neovascular AMD in the fellow eye at baseline, % | 33 | Bressler et al. 2003[14] | |
Probability of developing neovascular AMD in the fellow eye, per month | 0.0071 | AREDS report number 8b | |
Baseline BCVA, LogMAR letter score, mean (SD) for the PC lesion cohort | Treated eye | 46.5 (13.1) | ANCHOR trial data [3]; sampled from empirical trial data distribution |
Fellow eye without neovascular AMD at baseline | 77.4 (13.7) | ||
Fellow eye with neovascular AMD at baseline | 34.5 (26.1) | ||
Baseline BCVA, LogMAR letter score, mean (SD) for the OC/MC lesion cohort | Treated eye | 53.5 (13.2) | MARINA trial data;[5] sampled from empirical trial data distribution |
Fellow eye without neovascular AMD at baseline | 76.1 (14.7) | ||
Fellow eye with neovascular AMD at baseline | 38.6 (26.2) | ||
Distribution of lesion subtypes, % | No treatment | 27.5 | Assumptions established in Bressler et al. 2011[9] |
PC lesion cohort | 22.5 | ||
OC/MC lesion cohort | 50.0 | ||
Change in BCVA at 24 months | From empirical distributions | ANCHOR[3] and MARINA[5] trial data | |
Difference between monthly versus as-needed ranibizumab dosing in BCVA change at 24 months, letters (95% CI) | −2.1 (−5.2–1.0) | CATT study data[4] | |
Treatment discontinuation, monthly probability | Ranibizumab (PC lesions) | 0.00178 | ANCHOR (unpublished data, 2009)[9] |
Ranibizumab (OC/MC lesions) | 0.00173 | MARINA (unpublished data, 2006)[9] | |
Photodynamic therapy | 0.00407 | ANCHOR (unpublished data, 2009)[9] | |
Patients, by BCVA letter score, after 2 years without treatment in PC lesion cohort, % (SD) | ≤ 38 (worse than 6/60) in incident eye | 67 (5.16) | TAP report number 3c (predominantly classic CNV)d, SD reported in Bressler et al. 2011[9] |
≤ 38 (worse than 6/60) in better-seeing eye | 22.3 (0.05) | TAP report number 3d and ANCHOR[3] | |
≤ 68 (worse than 6/12) in incident eye | 97.0 (1.86) | Assumption from Bressler et al. 2011[9] | |
≤ 68 (worse than 6/12) in both eyes | 52.6 (0.10) | Estimated based on TAP report number 3c , d | |
BCVA change per month after discontinuation from active treatment, % | 1.6 | Based on 2-year sham-treatment results in MARINA (−14.9 letters in 24 months)[5] |
Pharmaceutical Benefits Scheme. Ranibizumab. (Accessed September 2013 from www.pbs.gov.au). 2011.
A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol 2001; 119: 1417–1436.
The mean baseline visual acuity of patients in TAP report number 3 is a 50-letter score.
Bressler NM, Arnold J, Benchaboune M, Blumenkranz MS, Fish GE, Gragoudas ES et al. (2002) Verteporfin therapy of subfoveal choroidal neovascularization in patients with age-related macular degeneration: additional information regarding baseline lesion composition's impact on vision outcomes-TAP report No. 3. Arch Ophthalmol 120: 1443–1454.
AMD: age-related macular degeneration; BCVA: best-corrected visual acuity; CI: confidence interval; CNV: choroidal neovascularization; OC/MC lesion: occult with no classic lesions or minimally classic lesions; PC lesion: predominantly classic lesions; SD: standard deviation; SE: standard error.