Clinical leaders across 120 Clinical Commissioning Groups are urging the GMC, Department of Health and NHS England to consider commissioning eye care services using the drug Avastin ‘off licence’.
Avastin (bevacizumab) has been found in clinical trials to be safe and effective for patients with wet-AMD. It is also cheaper than the officially approved treatment, Lucentis (Ranibizumab).
Avastin is licensed for the treatment of some cancers, but does not have a licence for use in AMD.
Dr Amanda Doyle, co-chair of NHS Clinical Commissioners said: “This is a long standing issue within the NHS and the numbers of CCGs who have united behind this shows the strength of feeling there is to ensure that we have all the available options to be able to deliver the best possible care for our patients.
“As clinicians we are seeing an increase in the incidence of this chronic eye condition due to an ageing population, and as commissioners we have a responsibility to ensure that every pound spent is done so to the best effect, and that is even more important with the current financial pressures the NHS is facing”
She added: "Members of the public would be baffled if they knew the sums of money being spent on expensive drugs when there is an alternative available that is cheaper and as effective.” It has been estimared that Avastin could save the NHS around £102m per year.
Clinical commissioners are asking:
the GMC to provide a specific exception to their standard guidance to support practitioners who wish to prescribe Avastin off-licence for use in the eye on the basis of clinical and cost effectiveness
Government to authorise NICE to undertake an multiple treatment appraisal looking the comparative cost effectiveness of Avastin with Lucentis and Eylea - the two currently licenced drugs for Wet AMD
Simon Stevens at NHS England to support the case for change and to support clinical commissioners who wish to make commissioning decisions to prescribe Avastin ‘off-licence’ on the grounds that it is safe and a cost effective treatment.
A Department of Health spokesperson said: “AMD is a very serious condition, and there are already other licensed and NICE-recommended drugs available to treat this condition.
"Avastin is not licensed for this purpose and whilst only the manufacturer is able to apply for a new licence, doctors are free to prescribe unlicensed medicines and licensed products off label if they feel they are clinically appropriate for their patients.”