Glaucoma generics 'could save NHS millions'

GPs have been urged to prescribe a generic glaucoma drug as first-line treatment to save the NHS millions of pounds a year, as part of a drive to improve NHS care for the disease.

Glaucoma represents a large proportion of the £2bn a year NHS budget for vision services (Photo: iStock)
Glaucoma represents a large proportion of the £2bn a year NHS budget for vision services (Photo: iStock)

The expiry of the patent for Xalatan (latanoprost) eye drops alone is expected to save the NHS around £16m a year, according to a report by the College of Optometrists and the Royal College of Ophthalmologists (RCO). Other patents for glaucoma drugs are due to expire in 2014.

The colleges urged GPs and eye care professionals to begin 'actively recommending generic latanoprost as first line treatment for glaucoma for appropriate patients'.

CCGs could invest the money saved in earlier surgery for patients with chronic open-angle glaucoma to reduce future medication costs further.

The report also advises CCGs to create local registers of glaucoma patients to check that care meets the NICE quality standard.

GP leaders backed the report and said CCGs had a 'great opportunity' to improve glaucoma care.

Clinical priority
Glaucoma is one of the most prevalent eye conditions and can cause severe visual impairment and blindness if left untreated. Although it cannot be prevented, its impact on sight can be minimised with early intervention.

Eye health now accounts for 4.5m GP consultations and costs the UK economy £22bn each year. From April, eye health will be a clinical priority for the RCGP the next three years.

The colleges' report, Commissioning Better Eye Care, advises CCGs how to improve NHS care for the 500,000 patients with glaucoma in England.

It said commissioners had failed to give sufficient attention to glaucoma in the past.

Although glaucoma represents a large proportion of the £2bn a year budget for vision services, data on the disease also tend to be poorer than for cataract or age-related macular degeneration.

The report made several recommendations, including:

  • A local glaucoma register to monitor compliance with NICE quality standard and avoid delays in follow-up
  • Repeat measurement and referral management schemes to reduce false-positive referrals to hospitals
  • Better support for patients with vision loss or trouble administering eye drops

Surrey GP Dr Charles Alessi, chairman of the National Association of Primary Care and NHS Clinical Commissioners, said: 'These new recommendations should be the first port of call for clinical commissioners who want to make the most of the great opportunities to improve eye care across the country.

'The NHS spends over £2bn on eye care in England alone, and this practical guidance brings together the most up to date evidence and insight about how to organise services as effectively and efficiently as we can.'

The patent for Xalatan expired in January 2012. An analysis of estimated cost savings by manufacturer Pfizer had suggested the NHS would save £16m a year from 2012. The NHS previously spent £52m on Xalatan, which was estimated to fall to £36m in 2012.

However, the college warned that generic latanoprost is not appropriate for all patients.

In 2014, other patents for glaucoma medications are due to expire, leading to further opportunities for generic prescribing, the report said.

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