Cost-effectiveness analysis of the use of faricimab in diabetic macular edema in China

<b>Aim:</b> Diabetic macular edema (DME) is one of the leading causes of vision impairment in diabetic patients. The aim of this study was to evaluate the cost-effectiveness of faricimab (Vabysmo^®), the first bispecific antibody targeting VEGF-A and ANG-2, for treating DME in China. <b>Materials & methods:</b> We conducted a cost-effectiveness analysis from the perspective of the Chinese health system using a Markov model to simulate long-term outcomes in DME patients. The model population was based on the Chinese subgroup from the RHINE trial, with a mean starting age of 58.7 years. Faricimab, administered according to a personalized treatment interval regimen following four initial monthly injections, was compared with aflibercept (every 8 weeks) and with ranibizumab and conbercept (both following a pro-re nata dosing regimen). The model incorporated clinical efficacy, adverse events, quality-adjusted life years and direct costs. Extensive sensitivity analyses (one-way and probabilistic) were performed to assess the robustness of the findings. <b>Results:</b> Over 20 years, faricimab gained 0.42, 0.61, 0.80 incremental quality-adjusted life years compared with aflibercept, conbercept, ranibizumab, while reducing treatment costs by 33,315 Chinese Yuan (CNY), 59,061 CNY and 12,314 CNY, respectively. Sensitivity analyses confirmed the robustness of these results, consistently demonstrating faricimab as a dominant and cost-effective treatment option for DME. <b>Conclusion:</b> This first Chinese cost-effectiveness study of faricimab for DME shows it enhances visual outcomes and reduces costs, supporting its adoption and providing evidence for healthcare decision-making on reimbursement and resource allocation.