Cheaper drug may avert blindness in older people

Avastin is a drug that is being used as a treatment for bowel cancer. However, it has been increasingly used, both in the United States and elsewhere in the world. to prevent blindness as a result of wet age-related macular degeneration (AMD). It is used split into tiny doses and injected into the eye.

The same manufacturers, Genentech based in the US have produced Lucentis, which is a derivative of Avastin and is made in the correct doses. The drawback is that it can cost 100 times more than an Avastin injection.

Lucentis having been clinically approved and licensed was then assessed for cost effectiveness by the National Institute for Health and Clinical Excellence (Nice). The price was expensive at £761.20 an injection so NICE had reservations about it. Then Novartis which promotes the drug in the UK offered to pay for treatment after 14 injections, which persuaded NICE to agree to its routine use by the NHS.

However, the NHS bill for use of the drug Lucentis became astronomical and therefore far less sustainable than had been anticipated. This is because thousands of people with wet AMD are queuing up for treatment and are remaining on it longer than expected. Every year the UK sees 26,000 of new cases of wet AMD, according to a Guardian report.

Now the Department of Health has asked NICE to consider assessing Avastin to treat eye disease even though the organisation normally assesses only licensed drugs.

In a statement NICE said that the department "has asked Nice to explore with stakeholders what value we can add in advising the NHS on the clinical and cost effectiveness of Avastin (bevacizumab) to treat wet age-related macular degeneration, the leading cause of blindness in the UK."

No doubt this move to consider Avastin as a cheap drug for eye disease will upset the drug companies which have been often criticised for its high prices. Already the Government has agreed to fund a head-to-head trial, called IVAN. of Lucentis and Avastin in wet AMD. The industry criticises the design and quality of the trial.

Cathi Yelt of the Macular Disease Society said: "We have quite a lot of anecdotes from around the country not just associated with the cost of Lucentis but the pressure on services because of the sheer numbers of people. There are more people in the system having treatment than was originally foreseen.

Everybody has been caught by surprise by the numbers."

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