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UPDATE: Greater Manchester PCTs react to Avastin off-licence use

The Association of Greater Manchester PCTs releases a statement following reports in the Guardian yesterday that doctors were prescribing Avastin off-label for wet-AMD to avoid the high costs of licensed drug Lucentis

The association of Greater Manchester PCTs has released a statement following reports in the Guardian yesterday that doctors were prescribing Avastin (bevacizumab) off-label for wet-age-related macular degeneration (wet-AMD) in order to avoid the high costs of licensed drug Lucentis (ranibizumab).

The PCTs state that Aventis will be used as part of a clinical trial at Manchester Royal Eye Hospital to begin in the next three months.

According to the PCTs, the local trial is awaiting research ethics approval and there is an intention to have further trials so a range of other questions about Avastin can be answered.

The PCTs are developing an interim position pending the commencement of the trial and the National Institute of Health and Clinical Excellence (NICE) guidance expected in the Q3 2007.

The interim position is likely to include the funding of Lucentis for some patients subject to strict eligibility criteria (around 20 per cent of affected patients may be treated with the drug). Any interim position adopted will be subject to an ongoing review in the light of the timetable for the local clinical trial establishment.

Steve Mills, CEO of Bury PCT speaking on behalf of the Association of Greater Manchester PCTs, said: ìThe PCTs in Greater Manchester have committed to using Avastin as part of a local clinical trial to be established as quickly as possible, and are in the meantime making arrangements for as many patients as possible to be treated with appropriate therapies.î

Media reports conflict with Manchester PCT groupís official stance
The above statement seems to contradict reports in the Guardian on 30 July, which said that PCTs have already taken the decision to offer Avastin on the NHS.

Peter Elton, director of public health for Bury PCT, was quoted by the Guardian as saying: ìWe think as many people as possible should be treated for wet-AMD. To afford it, we need to use Avastin.î

The report went on to say that Elton and his colleagues were happy with the clinical evidence amassed so far. Elton pointed out that Medicare, the state-funded healthcare service in the US, is using Avastin in 48 out of 50 states, as an alternative to Lucentis.

PMLive is currently awaiting clarification from Bury PCT one way or the other.

31st July 2007

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