As of 27 January 2026, the HTA Council has completed the evidence appraisal on the assessment of the following drugs for their respective indications, for possible government financing:

• first-line treatment of Diabetic Macular Edema (DME)
  • Aflibercept [40mg/mL solution for intravitreal injection]
  • Ranibizumab [10 mg/mL solution for intravitreal injection]
  • Dexamethasone implant [700 mcg intravitreal implant]
• first-line treatment of Macular Edema secondary to Retinal Vein Occlusion (ME-RVO)
  • Aflibercept [40mg/mL solution for intravitreal injection]
  • Ranibizumab [10 mg/mL solution for intravitreal injection]
  • Dexamethasone [700 mcg intravitreal implant]
• first-line treatment of wet Age-Related Macular Degeneration (wAMD)
  • Aflibercept [40mg/mL solution for intravitreal injection]
  • Ranibizumab [10 mg/mL solution for intravitreal injection]

The HTA Council hereby releases its preliminary recommendation on the said health technologies for stakeholder feedback and comments from 27 January to 10 February 2026.

These health technologies were reviewed against requirements for marketing authorization of the Philippine Food and Drug Administration (FDA), existing recommendations by the World Health Organization (WHO), clinical practice guidelines (CPGs) [developed by relevant local medical societies; and/or international CPGs adopted by the relevant local medical society]. Further, a costing analysis of the use of the health technologies was performed.

As a preliminary recommendation,the HTA Council recommends the following for government financing:

• Aflibercept [40mg/mL solution for intravitreal injection] as first-line treatment of DME, ME-RVO and wAMD; 
• Dexamethasone [700 mcg intravitreal implant] as alternative treatment for DME and ME-RVO for patients contraindicated or non-responsive to anti-vascular endothelial growth factor (VEGF) drugs; and 
• Ranibizumab [10 mg/mL solution for intravitreal injection] as first-line treatment of DME, ME-RVO and wAMD. 

This recommendation considers the role of anti-VEGF drugs as first-line therapy for DME, ME-RVO, and wAMD based on consultation with the relevant local medical society, current local and international CPGs, and the overall cost implications of using the treatment options. The recommendations on these health technologies and their indication/s are aligned with current local standards of care for first-line therapy and the alternative treatment for those contraindicated or non-responsive to first-line anti-VEGF drugs. 

Overall, current guidelines on DME indicate that anti-VEGF drugs (i.e., Aflibercept and Ranibizumab) are the first-line treatment for center-involved DME with vision loss, while corticosteroids (i.e., Dexamethasone implant) are reserved for patients with suboptimal response to anti-VEGFs or with chronic disease. Similarly for ME-RVO, anti-VEGF drugs (i.e., Aflibercept and Ranibizumab) are the first-line treatment of choice, while intravitreal corticosteroids (i.e., Dexamethasone implant) should be considered when patients have a failure to respond or have an inadequate response to anti-VEGF. For wAMD, Aflibercept and Ranibizumab are the preferred first-line treatment, with intravitreal anti-VEGF therapy considered the most effective approach. 

All treatments, however, incur significant costs. Hence, the DOH should strongly consider conducting price negotiation to ensure affordability and sustainable access to these treatments. Notably, considering the maximum number of injections required for each drug in patients with DME, Aflibercept shows considerably lower cost compared to Ranibizumab among the anti-VEGF drugs, whereas Dexamethasone implant shows the lowest cost overall for this indication. Meanwhile, assuming the use of the maximum number of injections for patients with ME-RVO, and comparing the anti-VEGF drugs, Aflibercept incurs lower costs than Ranibizumab, whereas Dexamethasone implant incurs the least cost overall. For wAMD, assuming the same number of injections, Aflibercept shows higher total annual treatment costs per patient and annual treatment cost for all patients compared to Ranibizumab.

For the supporting evidence reviewed and discussed by the HTA Council, please refer to the advisory and the evidence document below.

All comments, inputs, and/or appeals on the above preliminary recommendation may be submitted for the consideration by the HTA Council, through email at hta@dost.gov.ph. Please use the prescribed form for appeals indicated in the official HTA Philippines website [https://hta.dost.gov.ph/appeals-2/]. Appeals not following the prescribed format, and those submitted beyond the deadline shall not be entertained.

Should you have any questions or concerns regarding the preliminary recommendation, please contact us through the same email address.