Cost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial.


Scotland, Graham ORCID: 0000-0001-5539-8819, Tsehaye, Mekazin, Styles, Caroline, Logue, Jennifer ORCID: 0000-0001-9549-2738, Sammons, Emily, Zayed, Mohammed ORCID: 0000-0001-9816-983X, Emberson, Jonathan, Wade, Rachel ORCID: 0000-0001-9826-6322, Wallendszus, Karl, Stevens, Will et al (show 7 more authors) (2025) Cost-effectiveness of fenofibrate versus standard care for reducing the progression of diabetic retinopathy: An economic evaluation based on data from the LENS trial. Diabetic medicine : a journal of the British Diabetic Association, 42 (9). e70098-. ISSN 0742-3071, 1464-5491

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Abstract

<h4>Aims</h4>The LENS trial demonstrated that fenofibrate slowed the progression of diabetic retinopathy compared to placebo in participants with early diabetic eye disease. We assessed its cost-effectiveness for reducing the progression of diabetic retinopathy versus standard care from a UK National Health Service perspective.<h4>Methods</h4>Resource use and outcome data were collected over follow-up for participants enrolled in LENS. Mean costs were compared at 2 years and per 6-month follow-up (median 4.0 years). Within the trial, cost-effectiveness was assessed in terms of the incremental cost per case of referable disease averted. A microsimulation model, with inputs derived primarily from LENS trial data, was used to assess the incremental cost per quality-adjusted life year (QALY).<h4>Results</h4>Fenofibrate resulted in a mean (95% confidence interval) reduction in health service costs of -£254 (-1062 to 624) at 2 years and -£101 (-243 to 42) per 6-month follow-up. This was accompanied by a 4.4% (1.3% to 8.0%) absolute reduction in any referable diabetic retinopathy or treatment thereof at 2 years, and a 27% (9%-42%) relative reduction over follow-up. Modelled over 10 years, fenofibrate use cost an additional £6 per patient for an expected QALY gain of 0.02, costing £406 per QALY versus standard care under base case assumptions. The probability of cost-effectiveness varied from 70% to 79% at a threshold of £20,000 per QALY, depending on the price discount applied to anti-VEGF drugs.<h4>Conclusions</h4>Fenofibrate is likely to offer a cost-effective treatment for slowing the progression of diabetic retinopathy in people with early to moderate diabetic retinopathy or maculopathy.

Item Type: Article
Uncontrolled Keywords: LENS Collaborative Group, Humans, Diabetic Retinopathy, Diabetes Mellitus, Type 2, Disease Progression, Follow-Up Studies, Quality-Adjusted Life Years, Middle Aged, Cost-Benefit Analysis, Female, Male, Hypolipidemic Agents, Fenofibrate, United Kingdom
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 07 Aug 2025 10:07
Last Modified: 06 Sep 2025 02:04
DOI: 10.1111/dme.70098
Related Websites:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3193962
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