NICE U Turn to save thousands of peoples’ sight
For the first time a drugs company will pay to top up patients’ treatment where the level of care paid for by the Health Service is not enough.
In a decision that marks a climbdown for the National Institute for health and Clinical Excellence (NICE), the first 14 injections of the sight-saving drug Lucentis will be paid for by the NHS.
If the patient still needs further treatment then Novartis, the manufacturer, will pay for any additional doses.
The ruling overturns previous draft guidance that patients would have to go blind in one eye before receiving treatment with Lucentis, which costs more than £10,000 per eye, on the second.
It also paves the way for other new drugs for which top-up doses may be required to be funded in the same way in future.
Richard Barker, director general of the Association of British Pharmaceutical Industry suggested other medicines the NHS cannot afford to pay for in full could be provided through cost sharing schemes between the NHS and the drugs industry.
A similar approach has been suggested for kidney cancer drug Sutent, which costs £24,000 a year, and three other drugs after Nice issued draft guidance saying that they were not “cost effective” despite extending life by two months.
NICE has been severely criticised in recent months by health campaigners, who have accused them of condemning patients to “an early grave” by denying them the drugs.
It has also been at the centre of a previous controversy over its decision to deny the £2.50-a-day drug Aricept to victims of Alzheimer’s in the early stages of the disease.
Lucentis can stop the deterioration in sight caused by the condition wet age related macular degeneration (AMD), which affects about 250,000 people in the UK including 26,000 new cases each year. It can cause blindness within three months.
Up until now around 40 per cent of primary care trusts have refused to fund the drug while others have approved its use only in ‘exceptional cases’ although the drug was approved in Scotland last year.
Nice has taken over two and a half years to issue its final guidance on the drug in which time many thousands of people have already gone blind as a result of the condition. The drug has no effect on the condition once the patient has gone blind.
Andrew Dillon, NICE Chief Executive, said the decision would be justified by both the improved quality of life for patients and cost savings in the long run.
“Lucentis is an expensive drug, costing more than £10,000 for each eye treated,” he said. “But that cost needs to be balanced against the likely cost savings. AMD results in reduced quality of life and increased risks of illness, particularly in relation to accidents – especially falls – and psychological ill-health.
“Studies have also demonstrated that patients with visual impairment tend to have longer hospitalisations, make greater use of health and community care services and are more likely to be admitted to nursing homes.
Steve Winyard, Head of Campaigns at Royal National Institute for the Blind, said: “We’ve been waiting for this for over two years. It is a victory for thousands, bringing overwhelming relief to desperate people across the country. Finally the torment faced by elderly people forced to either spend their life savings on private treatment or go blind, is over.
“NICE’s guidance will finally bring an end to a cruel postcode lottery.”
Primary care trusts in England and Wales now have three months to fund the treatment for all eligible patients.
Lucentis is being provided through the country’s first dose capping scheme, which sees the NHS funding treatment only up to a given stage, in this case 14 injections.
The decision comes after Health Secretary Alan Johnson ordered an investigation into the policy of denying NHS services to patients in England who top up their care with private treatment.
Currently, anyone who pays for any private care can be barred from receiving the normal package of NHS care but the review will look at whether such co-payments should be allowed in future.
In July, RNIB also backed three pensioners in landmark High Court action against Warwickshire PCT for denying them treatment.
Tom Bremridge, chief executive of The Macular Disease Society said: “Those responsible for NICE should be aware that during the cumbersome two year review process 152 PCTs have individually had the power to decide whether to let patients go blind or to save their sight. The resulting stress and suffering has been cruel and unnecessary.
“Many hundreds of vulnerable patients have been subjected to an appalling emotional rollercoaster ride for the past two years – during which many of them have lost their remaining sight.”
Health direct points out that labour’s NHS cash constraints blocked the use of
over a year ago.
On June 14, 2007 Health Direct posted
Cruel watchdog NICE condems 20,000 to blindness
Twenty thousand people will be condemned to blindness each year following a “cruel” and “appalling” decision by the health watchdog NICE, campaigners said today. The National Institute for Health and Clinical Excellence (aka National Institute for Curbing Expenditure) has come under intense pressure to approve the drugs Lucentis (ranibizumab) and Macugen (pegaptanib) for use on the NHS.
The drugs treat wet age-related macular degeneration (AMD), which affects around a quarter of a million people. Wet AMD is the leading cause of sight loss in Britain, with 26,000 new cases each year.