2 The technology
2.1 Dexamethasone intravitreal implant (Ozurdex, Allergan) contains a corticosteroid. It suppresses inflammation and prevents oedema. Dexamethasone intravitreal implant has a marketing authorisation in the UK for 'the treatment of adult patients with visual impairment due to diabetic macular oedema who are pseudophakic or who are considered insufficiently responsive to, or unsuitable for, non‑corticosteroid therapy'.
2.2 Dexamethasone intravitreal implant is given as an injection into the eye. Each implant delivers 700 micrograms dexamethasone to the back of the eye over a period of 6 months or more. The implant remains in the vitreous for up to 270 days before fully dissolving. The summary of product characteristics states that, after initial treatment, re‑treatment can be performed after approximately 6 months if the patient experiences decreased vision with or without an increase in retinal thickness with recurrent or worsening diabetic macular oedema. The summary of product characteristics states that patients should be monitored following an injection of dexamethasone intravitreal implant.
2.3 The summary of product characteristics includes the following adverse events as common or very common for dexamethasone intravitreal implant: headache, increased intraocular pressure, cataract and conjunctival haemorrhage. For full details of adverse reactions and contraindications, see the summary of product characteristics.
2.4 The list price of dexamethasone intravitreal implant is £870.00 per 700 micrograms (excluding VAT; British national formulary, accessed online January 2015). In the company's model, dexamethasone intravitreal implant was assumed to have a total cost of £986.68 for treating unilateral disease and £1944.19 for bilateral disease. Costs may vary in different settings because of negotiated procurement discounts.