Diabetes charity attacks NICE over drug veto

Diabetes UK has criticised a decision by NICE not to recommend a drug for treating diabetic macular oedema (DMO), saying it will lead to more people 'needlessly' losing their sight.

Ranibizumab, marketed under the tradename Lucentis, is approved to treat age-related macular degeneration (Photograph: Dr P. Marazzi/SPL)
Ranibizumab, marketed under the tradename Lucentis, is approved to treat age-related macular degeneration (Photograph: Dr P. Marazzi/SPL)

In final draft guidance, the institute’s appraisal committee claimed ranibizumab (Lucentis) for DMO is too expensive and not an effective use of NHS resources.

Diabetes UK criticised the ruling. A spokesman for the charity said: ‘This decision means more people will needlessly lose their sight. We pressed hard to make this treatment available on the NHS and we will campaign for NICE to reconsider its decision.

He added: ‘The cost of looking after people with sight loss far outweighs the cost of Lucentis treatment, let alone the human cost.’

The charity said it was ‘very concerned’ that local health services will now stop treatment with the drug following the decision.

NICE already recommends ranibizumab for people with wet age-related macular degeneration.

The Diabetes UK spokesman added: ‘We will monitor the situation across the country closely to ensure patients currently receiving Lucentis continue to do so as per the NICE guidance. We would also like to see urgent testing into alternative treatments for diabetic macular oedema.’

DMO affects 50,000 people with diabetes in the UK. The condition causes an accumulation of protein on the macula of the eye, which thickens and distorts a person's vision.

The NICE appraisal compared ranibizumab with laser photocoagulation, the current standard treatment for people with DMO that uses heat to seal blood vessels in the eye.

NICE chief executive Sir Andrew Dillon said the institute was ‘acutely aware’ of the substantial negative effect on quality of life caused by the disease.

He said the manufacturer submitted evidence for a cost per quality-adjusted life year (QALY) gain that was within the upper limit of NICE’s acceptable threshold for effective use of resources.

Sir Andrew said: ‘However, the committee found that the manufacturer's analyses were based on implausible assumptions. The committee considered that, had a more plausible set of assumptions been used, the resulting cost per QALY gained would substantially exceed this range.’

NICE said that patients currently receiving ranibizumab for CMO should have the option to continue treatment until they or their doctors feel it is appropriate to stop.

The manufacturer, Novartis, said it was disappointed with the decision and said patients could ‘greatly benefit’ from the drug.

Ranibizumab is given as an injection into the eye. It prevents the production of the protein Vascular Endothelial Growth Factor (VEGF).

Ranibizumab costs £742.17 per injection and continues monthly until vision improves.

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