Posted by Michael Wonder on 01 Oct 2018
Age-related macular degeneration: treatment at what cost?
29 September 2018 - An estimated 8·4 million people worldwide have moderate to severe vision loss caused by age-related macular degeneration.
The main drawback of this treatment is the cost. Each injection costs up to £800, and most patients require around eight injections per year. A third very similar drug, bevacizumab (Avastin), which costs only £28 per injection, had very similar efficacy to ranibizumab and aflibercep in several studies including the IVAN trial (funded by the UK Department of Health). Bevacizumab is widely used in other countries including the USA and Australia for AMD, and in the UK for other conditions that also cause neovascularisation (eg, diabetic retinopathy). But because it is not licensed for AMD in the UK, this cheaper alternative is not used widely in the NHS for this common condition.
On Sept 21, the UK High Court found in favour of 12 clinical commissioning groups in the northeast of England who were taken to court by Novartis and Bayer, the manufacturers of ranibizumab and aflibercept, for offering the cheaper unlicensed alternative, bevacizumab, to NHS patients. Bayer and Novartis are considering appealing the decision.
