Background: Retinal diseases are major contributors to disability, significantly affecting patients' quality of life. Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) represent a significant disease and economic burden in Colombia. Assessing the economic evaluation of available treatments is essential for the efficient allocation of healthcare resources. Objective: To estimate the cost-effectiveness and budget impact of using faricimab for the treatment of patients with DME and nAMD within the Colombian health system. Methods: This study used a 25-year Markov cohort model to estimate the cost-effectiveness of faricimab vs aflibercept, ranibizumab, and brolucizumab. We used the methodological guidelines of the local health technology assessment agency for conducting the cost-effectiveness and budget impact analysis. Transition probabilities and injection frequencies were derived from the literature. Drug prices were retrieved from public local databases. Quality-adjusted life years (QALYs) were assessed. The potential patient population for the budget impact analysis was estimated based on disease prevalence and expert consultations. Results: Faricimab treat-and-extend (T&E) was dominant vs aflibercept T&E (+0.22 QALYs), ranibizumab T&E (+0.55 QALYs), and brolucizumab for 8 to 12 weeks (+0.06 QALYs) in DME, generating cost savings (in US dollars) of 3849 , 1375, and 2824 , r e s p e c t i v e l y . I n n A M D , f a r i c i m a b a l s o s h o w e d d o m i n a n c e v s a f l i b e r c e p t a s n e e d e d ( + 0.12 Q A L Y s ) , r a n i b i z u m a b a s n e e d e d ( + 0.05 Q A L Y s ) , a n d b r o l u c i z u m a b 8 t o 12 w e e k s ( + 0.12 Q A L Y s ) w i t h s a v i n g s i n ( U S ) 7223, 5792 , a n d 6798, respectively. Assuming an annual market share increase for faricimab of 15% for DME and 13% for nAMD, the Colombian Health System could save 144 m i l l i o n o v e r 3 y e a r s . O f t h e s e s a v i n g s , 122.7 million are attributed to drug costs and 21.3 m i l l i o n t o a d m i n i s t r a t i o n c o s t s ( U S 1 = Col$4325). Conclusion: Considering a willingness to pay threshold of $5988 per additional QALY, faricimab is a cost-effective alternative for both DME and nAMD for the Colombian healthcare system, showing dominance over other anti-vascular endothelial growth factor agents. Faricimab provides better health outcomes at lower costs vs other treatments.