Real-World Cost Evaluation of Conbercept vs Ranibizumab for Retinal and Choroidal Vascular Diseases from 2021 to 2024: Evidence from Societal and Medical Insurance Perspectives

Leading blindness causing retinal and choroidal vascular diseases including age-related macular degeneration (AMD), retinal vein occlusion (RVO), diabetic macular edema (DME), and choroidal neovascularization secondary to pathologic myopia (PM) treated with Conbercept and Ranibizumab impose a heavy economic burden. The Markov model was constructed based on best-corrected visual acuity, real-world injection frequencies in Tianjin (2021–2024), costs, utility values, and transition probabilities derived from clinical trials. From both the societal and medical insurance perspectives, conbercept was more cost-effective than ranibizumab in BRVO, CRVO, DME, and PM with Incremental cost-effectiveness ratios (ICER) as 442,423.176, -2,429,628.701, -69,339.384, 410,661.276 RMB/QALY under the societal perspective, and − 370,506.503, -2,491,085.315, -66,253.162, -432,736.475 RMB/QALY under the medical insurance perspective in 2023, respectively. In contrast, ranibizumab consistently showed greater effectiveness for AMD, with conbercept's ICER reaching 53,927.073 RMB/QALY in 2024 under the medical insurance perspective. These findings provide economic evidence to support value-based decision-making anti-VEGF therapy in China.