Hutton DW, Stein JD, Glassman AR, et al. - By performing this preplanned secondary analysis of a randomized clinical trial, researchers assessed 5- and 10-year cost-effectiveness of therapy with ranibizumab, 0.5 mg, vs panretinal photocoagulation (PRP) for treating proliferative diabetic retinopathy (PDR). Participants were 213 adults having a mean (SD) age of 53 (12) years. The study sample comprised 92 (43%) women and 155 (73%) whites. For participants with and without center-involved diabetic macular edema (DME) [CI-DME] and vision loss (Snellen equivalent, 20/32 or worse) at baseline, the assessment of incremental cost-effectiveness ratios (ICERs) of ranibizumab therapy vs PRP was performed. They found that the ICER of the ranibizumab group vs PRP was $582,268 per quality-adjusted life-year (QALY) and $742,202/QALY at 5 years and at 10 years, respectively, for patients without CI-DME at baseline, and was $65,576/QALY at 5 years and $63,930/QALY at 10 years for those with baseline CI-DME. Findings revealed that during 5 to 10 years of treatment, ranibizumab, 0.5 mg, as administered in the studied trial vs PRP may fall within the commonly cited range regarded cost-effective in the United States for eyes presenting with PDR and vision-impairing CI-DME, but not for those with PDR but without vision-impairing CI-DME. Ranibizumab therapy may be cost-effective within this range even for patients without baseline CI-DME if anti–vascular endothelial growth factor cost is decreased substantially.