Background In June 2013, it was decided to start a protocol for the use of ranibizumab. Patients were grouped in order to fractionate vials in 0.5 ml syringes as a savings strategy under aseptic conditions. 3 doses of ranibizumab suitable for use are obtained from each vial (0.5 mg/0.05 ml).

Purpose To evaluate and quantify the financial impact of the optimised use of ranibizumab.

Material and methods Data were collected from patients treated with ranibizumab from June 2012 to May 2013, and were compared with patients treated from June 2013 to May 2014, analysing the cost without such optimisation. Total consumption of vials and fractions, the number of patients and the different diagnoses were analysed. Data sources: DOMINION dispensing program.

Results 240 patients were treated from June 2012 to May 2013: 213 (88.75%) with exudative age-related macular degeneration (ARMD) (516 doses), 16 (6.66%) with diabetic macular oedema (24 doses), 10 (4.16%) with neovascularization secondary to pathological myopathy (14 doses) and 1 (0.41%) with macular oedema secondary to retinal vein occlusion (3 doses). The cost of ranibizumab without fractionation was €430,462. 400 patients were treated from June 2013 to May 2014: 364 (91%) with ARMD (1,140 doses), 29 (7.25%) with diabetic macular oedema (57 doses), 6 (1.5%) with neovascularization secondary to pathological myopathy (13 doses) and 1 (0.25%) with neovascular glaucoma (2 doses). The cost without fractionation would have been €1,029,124. However, due to fractionation it was €440,336 achieving a saving of €588,788 (714 vials) in one year, with an average of €1,471 per patient.

Conclusion The grouping of patients and the fractionation of ranibizumab vials reflects an increase in the burden of care and results in significant savings for the health system. The pathology for which the use of ranibizumab increased was ARMD, around 90%.

References and/or acknowledgements No conflict of interest.