Wonder eye drug brings hope to thousands

Thousands of people with a devastating eye disease could have their sight saved by a drug being made available on the NHS under new guidelines published today.

The National Institute for Health and Clinical Excellence (Nice) has recommended the drug Lucentis after performing a u-turn on draft guidance published last year.

The move was welcomed by the Royal National Institute for the Blind (RNIB), which has campaigned for Lucentis for thousands of people with wet age-related macular degeneration (AMD).

AMD is the leading cause of sight loss in the UK and destroys the central region of the retina, the macula, leading to progressive loss of sight.

It comes in two forms - wet and dry - with the dry form being far more common.

However the wet type is the more aggressive and accounts for around 90 per cent of blindness caused by the condition.

The final guidance, which applies to England, Wales and Northern Ireland, recommends Lucentis (also called ranibizumab) for treating wet AMD.

The drug is already approved in Scotland.

The guidance rejects another drug - Macugen (pegaptanib) - as not cost-effective.

In December, Nice dropped one of the most controversial aspects of its draft guidance, which suggested that patients would need to lose sight in one eye before the other could be treated.

Nice recommends the use of Lucentis as long as several conditions are met in the eye to be treated.

These include evidence of recent progression of the disease and no permanent structural damage to the central fove - the centre most part of the macula.

It also states that the NHS will only fund 14 injections, with the cost of any more being met by the manufacturer, in this case Novartis.

This "dose-capping" scheme was recommended by Novartis and has been agreed with the Department of Health. It will see Novartis reimburse the NHS for any additional jabs.

The cost of a single Lucentis injection is £761.20 (excluding VAT).

The two-year cost of Lucentis is about £10,700, assuming eight injections in the first year and six injections in the second year.

Andrew Dillon, Nice chief executive, said today: "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."

AMD results in reduced quality of life and increased risks of illness, particularly in relation to accidents - especially falls - and psychological ill-health, he pointed out.

Studies have also demonstrated that patients with visual impairment tend to have longer hospital stays, make greater use of health and community care services and are more likely to be admitted to nursing homes.

"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 Mr Dillon. "Our guidance means that patients who are suitable for this treatment will have the same access to it, irrespective of where they live."

Steve Winyard, head of campaigns at the RNIB, welcomed the news and called on PCTs to implement the Nice guidance immediately.

He said: "We've been waiting for this for over two years.

"It is a victory for thousands, bringing overwhelming relief to desperate people across the country.

"Finally the torment faced by elderly people forced to either spend their life savings on private treatment or go blind, is over.

"Nice's guidance will finally bring an end to a cruel postcode lottery."

There are 26,000 new cases of wet AMD in the UK each year. The condition can lead to blindness in as little as three months if left untreated.

The RNIB and the Macular Disease Society said they had supported almost 1,000 patients in their battles against PCTs for access to sight drugs.

Tom Bremridge, chief executive of the Macular Disease Society, said: "We are very pleased and relieved that Nice has issued this long-awaited final guidance.

"Thousands of patients with the wet type of macular degeneration, who are at grave risk of losing their precious, remaining sight quite suddenly, have prayed for this day to arrive. That day is finally here.

"Many hundreds of vulnerable patients have been subjected to an appalling emotional rollercoaster ride for the past two years - during which many of them have lost their remaining sight."

Dr Rafiq Hasan, director of market access and ophthalmics at Novartis, said: "The reimbursement scheme is an innovative approach which shows how pharmaceutical companies can work together with Nice and the Department of Health to ensure patients do get access to treatments on the NHS.

"Rapid implementation of the guidance is now needed to ensure that patients receive the treatment they need as soon as possible."