NICE gives Novartis' Lucentis a final no for diabetic macular oedema

NICE has refused to back Novarits' eye drug Lucentis (ranibizumab), saying its use to treat diabetic macular oedema was not a good use of NHS resources.

The UK cost effectiveness watchdog's final guidance was also critical of the evidence the pharma company provided to support its submission.

NICE's independent Appraisal Committee said this did not provide a true reflection of the cost-effectiveness for Lucentis monotherapy compared with the current standard treatment.

This is laser photocoagulation, which uses heat to seal ocular blood vessels in people with diabetic macular oedema (DMO).

Sir Andrew Dillon, Chief Executive at NICE said: ”NICE already recommends ranibizumab for wet age-related macular degeneration, and although it has been shown in some clinical trials to be an effective treatment for DMO, we could not recommend the drug as a clinically and cost-effective use of NHS resources compared with laser photocoagulation for this condition.

“The manufacturer's analysis produced a cost per quality-adjusted life year gained that was at the higher end of what NICE considers to represent an effective use of NHS resources. But the Committee concluded that the manufacturer's analyses were based on implausible assumptions, and that had a more plausible set of assumptions been used, the resulting cost per quality-adjusted life year gained would have exceeded this range.”

Lucentis costs £742.17 per injection, with treatment given monthly and continued until a patient achieves maximum vision.

NICE said that people being treatment with Lucentis for DMO should have the option to continue treatment until they and their clinicians feel it is appropriate to stop.

The Institute last week issued draft guidance on Lucentis in another indication, this time as a treatment for visual impairment caused by macular oedema secondary to central or branch retinal vein occlusion (RVO).

NICE's  guidance in that indication did not recommend the drug's use either. The decision has been put out to consultation and final guidance likely to be published in March 2012.