Doctors are calling on NHS England and health ministers to make the drug Avastin readily available to patients with the debilitating eye condition wet age-related macular degeneration (wet AMD).
Macular degeneration starts when the part of the eye responsible for central vision (macular) starts to deteriorate. Age-related macular degeneration (AMD) usually affects people over 60. It is the most common cause of loss of sight in the developed world, with over 600,000 people affected in the UK, half of whom are registered as visually impaired. Wet AMD is caused when abnormal blood vessels grow into the macula, leading to a gradual loss of central vision. About 10 per cent of all people with AMD have wet AMD.
An article in The Telegraph has highlighted a recent trial in the UK showing that the drug Avastin has a similar effectiveness to the drug Lucentis which is currently licensed for treating wet AMD. Lucentis is far more expensive than Avastin, costing £700 per injection as opposed to £60 for Avastin. (Currently, Avastin is only licensed for cancer treatment.) The authors of the study argue that switching to Avastin could save the NHS £102 million a year.
The Telegraph reports that clinical leaders from 120 commissioning groups say current regulations make it hard for physicians to prescribe Avastin. Although doctors are able to prescribe Avastin “off-label”, they are only meant to do this if there is no other suitable licensed drug. Dr Amanda Doyle, co-chair of NHS Clinical Commissioners, said: "This is a long standing issue within the NHS, and the numbers of CCGs who have united behind this shows the strength of feeling there is to ensure that we have all the available options to be able to deliver the best possible care for our patients. As clinicians, we are seeing an increase in the incidence of this chronic eye condition due to an ageing population, and as commissioners we have a responsibility to ensure that every pound spent is done so to the best effect, and that is even more important with the current financial pressures the NHS is facing."
A spokesman for the Department of Health said: “[AMD] is a very serious condition and there are already other licensed and NICE-recommended drugs available to treat this condition. However, Avastin is not licensed for this purpose and whilst only the manufacturer is able to apply for a new license, doctors are free to prescribe unlicensed medicines and licensed products off label if they feel they are clinically appropriate for their patients."
Given the current financial constraints and the pressure on resources faced by the NHS, it is vital that patients receive cost-effective treatment. Camilla Wonnacott, associate at Penningtons Manches, said: “Delay in diagnosing and treating AMD can be devastating for the patient and, ultimately, can cost the NHS a good deal more than if a patient had been diagnosed and treated at an earlier stage. Ensuring treatment is provided in a timely and cost-efficient manner is paramount so that patients receive sustainable and appropriate care for this increasingly common condition.”