Background Antiangiogenic drugs are the treatment of choice for age-related macular degeneration (AMD). They are expensive due to the high cost of vials and absence of commercial syringes with the necessary dose.

Purpose To compare the efficiency of alternative treatments available for AMD, ranibizumab and aflibercept, when optimising vials to prepare syringes with exact doses in the pharmacotechnical unit of the Pharmacy Service.

Material and methods Retrospective study, from May 2013 to May 2014, of patients with AMD. The therapeutic option was ranibizumab, aflibercept was not yet allowed in the hospital. Data were obtained from medical prescriptions and computer records of the pharmacotechnical unit. To compare what treatment would have been more cost effective we considered the same patients and the same number of syringes of aflibercept as of ranibizumab in that period. We obtained three syringes of ranibizumab from each vial, and we would have obtained four syringes from each vial of aflibercept, when preparing the necessary dose. Variables studied: number of patients, number of syringes, cost of vials and cost of syringes.

Results During the study period, 1,179 syringes of ranibizumab were prepared, for 151 patients, corresponding to 7.8 syringes per patient. These syringes were obtained from 393 vials of ranibizumab. If we had used the corresponding number of vials, the cost would have been €815,219.55. However, the development cost of these syringes was €271,739.85. The costs with aflibercept would have been, using 1,179 vials, €759,912.66, and syringes, from 295 vials, €190,139.3. The difference between treatments was €55,306.89.

Conclusion The optimisation of the ranibizumab and aflibercept vials saves money for the health system, as well as providing greater accuracy and safety when preparing these sterile syringes in the Pharmacy Service. Assuming equivalence in effectiveness, we propose aflibercept as the more cost-effective treatment.

References and/or acknowledgements No conflict of interest.