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NHS may permit off-licence use of Avastin in wet-AMD

According to a Guardian newspaper report, NHS doctors are planning to give patients with wet-AMD a similar drug that is used to prevent blindness in the US to avoid the high price of licensed treatment, Lucentis

A report in the UK campaigning newspaper the Guardian has said that NHS doctors are planning to give patients with wet age-related macular degeneration (wet-AMD) a similar drug that is used to prevent blindness in the US to avoid the high price of licensed treatment, Lucentis (ranibizumab).

Avastin (bevacizumab), which is currently licensed for bowel cancer but not for wet-AMD, is a much cheaper treatment than Lucentis, which is fully licensed to treat the condition. Both drugs are manufactured by US biotech, Genentech.

Lucentis costs around GBP 761.20 for a 0.3ml shot, compared with around GBP 10 per shot of Avastin. One bowel cancer phial can be split into several doses for injection into the eyes.

The Department of Health (DoH) says is now funding a clinical trial to compare Avastin and Lucentis. 

Primary Care Trusts (PCTs) in the Greater Manchester area in the UK have decided to offer patients Avastin off-label on the NHS, while Moorfields eye hospital in London is said to be considering prescribing the drug.

Medicare, the state-funded US healthcare service, is currently using Avastin to treat wet-AMD in 48 out of 50 states.

In February 2007, Patricia Hewitt, former health secretary, urged Genentech and its marketing partner Roche, to stop blocking the use of Avastin for AMD and to put it through the trials necessary to receive a licence.

The National Institute of Health and Clinical Excellence (NICE) cannot evaluate the drug unless the companies gain a licence for treating wet-AMD.

"Licensing involves an assessment of the safety, quality and efficacy of a drug for the treatment of a particular condition. Some doctors have reported promising results from using Avastin on an off-licence basis for the treatment of macular degeneration but NICE can only appraise a drug that has been subject to clinical trials and is licensed for the treatment of the condition in question. However if a patient is willing to be prescribed a drug off-label, it is available on the clinician's judgment and subject to funding by the PCT,î said a DoH spokesperson.

30th July 2007

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