The NHS has moved a step closer to obtaining a cheap drug to prevent the leading cause of blindness, in spite of attempts by drug companies to block it.
The National Institute for Health and Clinical Excellence (Nice), which decides which drugs may be prescribed on the NHS, has decided to move towards an official appraisal of a drug, Avastin, that has been widely and cheaply used to prevent wet age-related macular degeneration – even though the drug companies that make and market it refuse to seek a licence. They have a licensed version which is many times more expensive.
Avastin is licensed for bowel cancer, but ophthalmologists in the US discovered that – split into tiny doses suitable for injection into the eye – it could halt and even reverse the progress of wet AMD, which is the commonest cause of blindness. Eye specialists around the world have been using Avastin in this way, because splitting a vial into many tiny doses makes it relatively cheap.
But the manufacturer, Genentech, and the Swiss drugs company Roche, which markets Avastin in Britain, have fought this use. Genentech has produced and licensed a very similar but far more costly version, which it calls Lucentis, and which has been approved by Nice for the NHS.
The Royal Liverpool and Broadgreen University Hospitals pharmacy, which has been producing Avastin for eyes, charges £50 a dose. Mass production could bring the cost still lower. Lucentis costs around £750 a dose.
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