Condition

Macular Degeneration

Age-related vision loss

200M
People Affected
60
Active Trials
6M
New Cases/Year
8,000
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Aflibercept
90% Effectiveness• 98% Confidence• 45% Safety• 280 trials• 50K participants
HIGH EvidenceGood ValueDose: 2 mg intravitreal injection every 4 weeks for 3 months, then every 8 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
45
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

93%

Remission Rate

%

Common Side Effects:

Conjunctival hemorrhage: 15%
Eye pain: 8%
Vitreous floaters: 7%
Increased intraocular pressure: 3%
Endophthalmitis: 0.05%
Retinal detachment: 0.05%

Annual Cost of Care

Drug Cost

$12,000

Monitoring

$750

Side Effects

$300

Total Annual

$13,050

Cost-Effectiveness

GOOD

QALYs Gained

0.85

ICER

$80,000/QALY

Cost per Responder

$14,032.26

Treatment Outcomes
Primary Outcomes
Best Corrected Visual Acuity (BCVA)58 ETDRS letters (approx. 20/70 vision)
+21.55% (+12.5 ETDRS letters)
Central Retinal Thickness (CRT)420 µm
-25% (-105 µm)
Choroidal Neovascularization (CNV) Lesion Area1.5 mm²
-15% (-0.225 mm²)
Secondary Benefits
NEI VFQ-25 Composite Score72 points (out of 100)
+8.33% (+6 points)
Reading Speed70 words per minute (WPM)
+21.43% (+15 WPM)
Contrast Sensitivity1.5 log units
+10% (+0.15 log units)
Common Side Effects
Conjunctival hemorrhage
+15%
Eye pain
+8%
Vitreous floaters
+7%

Clinical Trial Phases:

Phase 3Phase 4
2
Faricimab
90% Effectiveness• 95% Confidence• 45% Safety• 26 trials• 10K participants
HIGH EvidenceGood ValueDose: 6 mg intravitreal injection monthly for 4 doses, then extended up to every 16 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
45
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

93%

Remission Rate

%

Common Side Effects:

Conjunctival hemorrhage: 15%
Eye pain: 8%
Vitreous floaters: 7%
Increased intraocular pressure: 3%
Endophthalmitis: 0.05%
Retinal detachment: 0.05%

Annual Cost of Care

Drug Cost

$10,000

Monitoring

$700

Side Effects

$300

Total Annual

$11,000

Cost-Effectiveness

GOOD

QALYs Gained

0.85

ICER

$85,000/QALY

Cost per Responder

$11,827.96

Treatment Outcomes
Primary Outcomes
Best Corrected Visual Acuity (BCVA)58 letters
+11% (+6 letters)
Central Subfield Thickness (CST)430 µm
-37% (-160 µm)
Pigment Epithelial Detachment (PED) Height250 µm
-24% (-60 µm)
Secondary Benefits
Annual Ocular Injections (after stabilization)7 injections/year
-43% (-3 injections/year)
National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) Total Score70/100
+9% (+6 points)
NEI VFQ-25 Near Vision Activities Score60/100
+12% (+7 points)
Common Side Effects
Conjunctival hemorrhage
+15%
Eye pain
+8%
Vitreous floaters
+7%

Clinical Trial Phases:

Phase 3Phase 4
3
Ranibizumab
88% Effectiveness• 98% Confidence• 45% Safety• 381 trials• 60K participants
HIGH EvidenceGood ValueDose: 0.5 mg intravitreal injection every 4 weeks, then individualized
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
45
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

92%

Remission Rate

%

Common Side Effects:

Conjunctival hemorrhage: 15%
Eye pain: 8%
Vitreous floaters: 7%
Increased intraocular pressure: 3%
Endophthalmitis: 0.05%
Retinal detachment: 0.05%

Annual Cost of Care

Drug Cost

$16,000

Monitoring

$750

Side Effects

$300

Total Annual

$17,050

Cost-Effectiveness

GOOD

QALYs Gained

0.8

ICER

$75,000/QALY

Cost per Responder

$18,532.61

Treatment Outcomes
Primary Outcomes
Best-Corrected Visual Acuity (BCVA)55 ETDRS letters
+22% (+12 ETDRS letters)
Central Subfield Thickness (CST) on OCT400 µm
-30% (-120 µm)
Contrast Sensitivity (Pelli-Robson chart)1.2 log units
+8% (+0.1 log units)
Secondary Benefits
National Eye Institute Visual Function Questionnaire (NEI VFQ-25) Score60/100
+10% (+6 points)
Microperimetry Mean Sensitivity15 dB
+10% (+1.5 dB)
Reading Speed (MNREAD Acuity Chart)80 words/minute
+15% (+12 words/minute)
Common Side Effects
Conjunctival hemorrhage
+15%
Eye pain
+8%
Vitreous floaters
+7%

Clinical Trial Phases:

Phase 3Phase 4
4
Bevacizumab
88% Effectiveness• 95% Confidence• 45% Safety• 130 trials• 55K participants
HIGH EvidenceExcellent ValueDose: 1.25 mg intravitreal injection every 4-8 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
45
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

92%

Remission Rate

%

Common Side Effects:

Conjunctival hemorrhage: 15%
Eye pain: 8%
Vitreous floaters: 7%
Increased intraocular pressure: 3%
Endophthalmitis: 0.05%
Retinal detachment: 0.05%

Annual Cost of Care

Drug Cost

$800

Monitoring

$750

Side Effects

$300

Total Annual

$1,850

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.8

ICER

$10,000/QALY

Cost per Responder

$2,010.87

Treatment Outcomes
Primary Outcomes
Best Corrected Visual Acuity (BCVA)55 ETDRS Letters (approx. 20/80 Snellen equivalent)
+18.2% (+10 Letters)
Central Retinal Thickness (CRT)400 µm
-30% (-120 µm)
Choroidal Neovascularization (CNV) Lesion Area2.5 mm²
-32% (-0.8 mm²)
Secondary Benefits
National Eye Institute Visual Function Questionnaire (NEI VFQ-25) Composite Score65 points (out of 100)
+10.8% (+7 points)
Contrast Sensitivity1.5 Log Contrast Sensitivity units
+10% (+0.15 Log Contrast Sensitivity units)
Common Side Effects
Conjunctival hemorrhage
+15%
Eye pain
+8%
Vitreous floaters
+7%

Clinical Trial Phases:

Phase 3Phase 4
5
Brolucizumab
85% Effectiveness• 90% Confidence• 35% Safety• 50 trials• 8K participants
HIGH EvidenceModerate ValueDose: 6 mg intravitreal injection monthly for 3 doses, then every 8-12 weeks
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
35
DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

lifetime

Response Rate

90%

Remission Rate

%

Common Side Effects:

Intraocular inflammation: 5%
Retinal vasculitis/occlusion: 3%
Conjunctival hemorrhage: 15%
Eye pain: 8%
Vitreous floaters: 7%
Increased intraocular pressure: 3%

Annual Cost of Care

Drug Cost

$12,000

Monitoring

$800

Side Effects

$1,500

Total Annual

$14,300

Cost-Effectiveness

MODERATE

QALYs Gained

0.75

ICER

$90,000/QALY

Cost per Responder

$15,888.89

Treatment Outcomes
Primary Outcomes
Best Corrected Visual Acuity (ETDRS letters)58 letters (approx. 20/80 Snellen)
+10.3% (+6 letters)
Central Subfield Thickness (CST)385 µm
-31.2% (-120 µm)
Proportion of eyes with intraretinal or subretinal fluid75% of eyes
-66.7% (-50 percentage points)
Secondary Benefits
NEI VFQ-25 Composite Score70 points (out of 100)
+7.1% (+5 points)
Proportion of eyes without any retinal fluid (IRF or SRF)20% of eyes
+150% (+30 percentage points)
Common Side Effects
Intraocular inflammation
+5%
Retinal vasculitis/occlusion
+3%
Conjunctival hemorrhage
+15%

Clinical Trial Phases:

Phase 3Phase 4
6
AREDS2 Formula Supplements
30% Effectiveness• 90% Confidence• 90% Safety• 1 trials• 30K participants
HIGH EvidenceExcellent ValueDose: Vitamin C 500 mg, Vitamin E 400 IU, Zinc 80 mg, Copper 2 mg, Lutein 10 mg, Zeaxanthin 2 mg, daily
Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
90
DangerousModerateSafe

Time to Effect

5+ years

Duration

lifetime

Response Rate

%

Remission Rate

%

Number Needed to Treat (NNT)

15

Common Side Effects:

Upset stomach/diarrhea: 5%
Yellowing of skin (harmless): 1%

Annual Cost of Care

Drug Cost

$400

Monitoring

$500

Side Effects

$15

Total Annual

$915

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

ICER

$1,000/QALY

Treatment Outcomes
Primary Outcomes
Progression to Advanced Age-Related Macular Degeneration (AMD)5-year cumulative risk of progression: 30%
-25% (-7.5 percentage points)
Incidence of Neovascular (Wet) AMD5-year cumulative incidence: 20%
-20% (-4 percentage points)
Risk of Severe Vision Loss (≥15 ETDRS letters)5-year cumulative risk: 15%
-19% (-2.85 percentage points)
Secondary Benefits
Macular Pigment Optical Density (MPOD)0.35 optical density units
+20% (+0.07 optical density units)
Contrast Sensitivity (log CS)1.5 log CS units
+10% (+0.15 log CS units)
NEI VFQ-25 Composite Score65/100
+5% (+3.25 points)
Common Side Effects
Upset stomach/diarrhea
+5%
Yellowing of skin (harmless)
+1%

Clinical Trial Phases:

Phase 3Phase 4