4CPS-057 Is the switch from intravitreal aflibercept and ranibizumab to faricimab an efficient and safe strategy?

<h3>Background and Importance</h3> Faricimab is a novel intravitreal drug licensed for neovascular age-related macular degeneration (nAMD) or diabetic macular oedema (DME). Faricimab’s wider administration-interval compared to its alternatives aflibercept and ranibizumab makes it a more convenient option and, therefore, most patients are switching to faricimab. However, faricimab is only an efficient option if unitary-dose syringes are prepared from multi-dose commercial vials in the Pharmacy Service’s clean rooms to maximise the fractioning of the vials. <h3>Aim and Objectives</h3> Given that health resources are limited and faricimab is a drug with elevated economic impact, the economic savings of unitary-dose syringes preparation was studied, as well as the efficacy and safety of switching from aflibercept/ranibizumab to faricimab. <h3>Material and Methods</h3> Retrospective, observational study in patients with nAMD or DME receiving at least 3 intravitreal injections in a regional, 105-beds hospital (November 2023 to August 2024). Efficacy variables: improvement in best-corrected visual acuity (VA) and reduction in macular oedema(ME). Safety: adverse reactions described in faricimab information sheet. Statistics: paired T-test. Unitary faricimab 6 mg/0.05 mL syringes were prepared. To assess the economic impact, direct costs were included: vials, material and elaborator personnel. <h3>Results</h3> 56 patients were included in the efficacy and safety analysis, 30 (53.6%) females, with median (range) age of 79 years (47–94), 42 (75%) diagnosed with nAMD and 14 (25%) with DME. After switching to faricimab, 28(50%) improved VA, 12(21%) remained stable and 16(29%) worsened. Regarding ME, 27(48%) improved, 12(21%) were stable and 17(31%) worsened. Only 4(7%) patients worsened in both variables, with a reduced administration-interval at present and pending reevaluation. There was a statistically significant difference in the mean administration-interval (standard deviation) between previous drug and faricimab [6.1 weeks (±2.2 weeks) vs 9.6 weeks (±2.4 weeks), p&lt;0.001]. One patient(3.6%) reported an abrupt acute decrease in vision lasting one hour after the seventh dose, with adequate resolution. 341 unitary syringes were prepared from 149 vials, with a final cost of 70.013€, which has supposed a saving of 88.671€ comparing to having used 341 vials of faricimab without fractioning (158.684€). <h3>Conclusion and Relevance</h3> Faricimab treatment leads to fewer intravitreal administrations, improving patients’ quality of life, in addition to being an effective and safe strategy. The single-dose-syringe production of faricimab in the Pharmacy Service represents a saving of 56% of the expenses. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest