· Two-year course will cost trusts up to £18,000 · Debate over similar but cheaper drug used in US list of 4 items Sarah Boseley , health editor The Guardian, Wednesday August 27 2008 Article history list end
An expensive new drug that could prevent thousands of people from going blind is today approved for use on the NHS after more than two years of deliberations. The National Institute for Health and Clinical Excellence (Nice) says that primary care trusts should foot the bill for Lucentis, which costs £761 for each injection, to prevent people with age-related wet macular degeneration from losing their sight. A two-year course of treatment will cost trusts between £10,700 and £18,300. To offset this, a deal has been struck with the drug company Novartis, which markets Lucentis in the UK. The company is to pay if people need further treatment after 14 injections. Andrew Dillon, chief executive of Nice, said: "Lucentis is an expensive drug, costing more than £10,000 for each eye treated. But that cost needs to be balanced against the likely cost savings. Age-related macular degeneration results in reduced quality of life and increased risks of illness, particularly in relation to accidents, especially falls, and psychological ill-health." Studies show that people with failing sight end up in hospital longer than they should, need more support from health and community services, and are more likely to end up in a care home. "It has been estimated that the costs related to sight impairment for patients treated with Lucentis are around £8,000 cheaper than for patients who receive best supportive care over a 10-year period," said Dillon. The Royal National Institute of Blind People, which has backed court cases brought against primary care trusts by people in need of treatment, was jubilant. "Nice's guidance will finally bring an end to a cruel postcode lottery," said Steve Winyard, head of RNIB campaigns. "There is now nowhere left for PCTs to hide - we want them to implement Nice guidance immediately. RNIB is also calling on hospitals to ensure they build capacity as a matter of urgency, so they can save the sight of patients without further delay." There are about 26,000 new cases of wet macular degeneration a year and the financial burden on the NHS of the treatments will be substantial. While the deliberations have been going on, a significant number of ophthalmologists have been treating patients with Avastin, a bowel cancer drug similar to Lucentis which works out much cheaper once each dose has been split into the tiny amounts needed for use in the eyes. Its use in the US is now widespread and there is a large body of evidence suggesting it is just as effective as Lucentis. Both Lucentis and Avastin are made by Genentech, but the firm refuses to put Avastin through trials for a licence for eyes, in spite of an invitation to do so from Patricia Hewitt when she was health secretary. Michael Lavin, a consultant ophthalmologist in Cheshire, who treats patients with Avastin, said: "At present, we cannot detect differences in effects, or risks, although Avastin may require fewer injections as it appears to last longer after each injection. So the taxpayer may wish to question why they are paying so much more for Lucentis, when Avastin appears to achieve the same outcome." Bury primary care trust decided some time ago to fund Avastin as a way of treating every patient in need. Its public health director, Peter Elton, said it would go on using the drug in preference to Lucentis. There are several clinical trials investigating the use of Avastin in eyes, one of which compares it with Lucentis. But Nice says it cannot assess cost-effectiveness as Avastin does not have a licence for use in eyes. http://www.guardian.co.uk/society/2008/aug/27/nhs.health Join Access India convention: For updates on it visit: http://accessindia.org.in/harish/convention.htm Registration is now open! To unsubscribe send a message to [EMAIL PROTECTED] with the subject unsubscribe. To change your subscription to digest mode or make any other changes, please visit the list home page at http://accessindia.org.in/mailman/listinfo/accessindia_accessindia.org.in
