Joint Assessment of Intended and Unintended Effects of Medications: An Example Using Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration

Table 4

Mean quality-adjusted life years associated with alternate intended effects scenarios incorporated over the duration of the model.

	Net Health Benefit
	Base Case	Scenario 1	Scenario 2
Ranibizumab	4.36 (4.19–4.52)	4.51 (4.34–4.69)	3.81 (3.60–4.03)
Pegaptanib	4.29 (4.14–4.45)	4.00 (3.81–4.17)	3.79 (3.57–4.02)

Scenario 1: Transition probabilities following the first year of treatment remained constant, with patients continuing to gain or lose vision at the same rate as during the trial period. Patients therefore continue accruing treatment benefit for the duration of the time horizon of the model.
Scenario 2: Treatment benefit was assumed to drop to zero after the first year of treatment and the transition probabilities were those of the usual care group.
Net health benefits were calculated by subtracting the net harms in each treatment from the benefit using the quality-adjusted life year as a common metric.