The NHS has won a legal battle against the pharmaceutical industry which will lead to patients with the most common form of blindness receiving a drug that is much cheaper but still very effective.
The high court backed a bid by 12 NHS clinical commissioning groups (CCG) in the north-east of England to give Avastin to people with worsening sight loss.
Though typically used to treat cancer, Avastin has also been proven to help tackle wet age-related macular degeneration (AMD). The decision could help the NHS save more than £100m a year because Avastin is 30 times cheaper than the two existing treatments, Lucentis and Eylea.
“It’s a victory for common sense over commercial interests,” said David Hambleton, the CCG chief officer in South Tyneside and former geriatrician.
He was speaking after the court rejected arguments made by the drug companies Novartis, which makes Lucentis, and Bayer, the manufacturer of Eylea. They had brought the action in an attempt to stop the NHS using Avastin rather than their much more expensive treatments.
There is a huge difference in price between the two existing treatments and Avastin for wet AMD. An injection of Lucentis or Eylea costs about £800. But a dose of Avastin costs just £28.
“The drug is undeniably equally effective, and much less expensive, and the money this will save – in excess of £13.5m per year for the 12 CCGs involved in this litigation alone, and hundreds of millions of pounds across the country – can be ploughed straight back into delivering the very best care possible to our patents,” Hambleton said.
The court backed the 12 CCGs, even though Avastin has only been licensed in the UK to treat cancer and not AMD. However, private hospitals in Britain use Avastin as their main treatment for AMD and the drug has also been widely used in the US and other countries for that purpose.
Hambleton said: “Novartis and Bayer have argued long and hard for the more expensive drugs they’d rather sell to be the only ones available to people suffering from this condition. But thankfully the court has recognised that there is no medical basis to that argument. This is great news for patients with this condition and for the wider NHS.”
The Royal National Institute of Blind People welcomed the ruling but demanded that the savings it produces should be used to improve NHS eyesight services to end the delays faced by patients to see a specialist.
“We are concerned that patients will be anxious about what this means for their treatment. It is critical each patient has the opportunity to have a full discussion with their clinician to give consent prior to switching or embarking on treatment”, said Helen Lee, the charity’s policy and campaigns manager.
“We know that some patients are permanently losing vision due to delayed and cancelled eye care appointments as services are struggling to cope with demand, so all savings generated by providing Avastin rather than licensed anti-VEGF drugs must be invested in eye care services.”