Objective To evaluate the efficacy, safety, and cost-effectiveness of faricimab in the treatment of diabetic macular edema (DME), thereby providing evidence-based guidance for clinical practice.

Methods A computerized search was conducted in PubMed, Embase, The Cochrane Library, as well as Chinese databases such as CNKI, WanFang, and VIP, and on the official websites of international Health Technology Assessment (HTA) organizations. The search covered HTA reports, systematic reviews/Meta-analyses, and pharmacoeconomic studies on faricimab for the treatment of DME, from the inception of each database through March 31, 2026. The quality of systematic reviews and Meta-analyses was assessed using the AMSTAR 2 tool, while the quality of pharmacoeconomic studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards criteria.

Results A total of 12 studies were included, comprising 1 HTA report, 6 systematic reviews/Meta-analyses, and 5 pharmacoeconomic studies. In terms of efficacy, faricimab was generally comparable to ranibizumab and aflibercept in improving best-corrected visual acuity, but showed superior efficacy in reducing macular thickness; visual acuity benefits were observed in certain specific subgroups, and it has a longer dosing interval. In terms of safety, the incidence of adverse events with faricimab showed no statistically significant difference compared with that of other anti-vascular endothelial growth factor (VEGF) drugs; in terms of cost-effectiveness, both domestic and international studies indicate that faricimab offered economic advantages over other anti-VEGF drugs in the treatment of diabetic macular edema.

Conclusions Faricimab demonstrates good efficacy and safety for the treatment of DME and offers economic advantages in China.

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