Only a fifth of patients allowed AMD drugs

Eighty per cent of patients in England and Wales with wet age-related macular degeneration (AMD) will be denied treatment under draft guidance issued by NICE.

If implemented, the guidance would severely restrict the use of the anti-vascular endothelial growth factor drugs ranibizumab (Lucentis) and pegaptanib (Macugen).

Both drugs have already been approved by the Scottish Medicines Consortium.

But the NICE guidance says that only the 20 per cent of patients in whom both eyes have been affected by wet AMD should be given ranibizumab and that it should only be used in the better-seeing eye. The use of pegaptanib is not recommended.

Kevin Gregory-Evans, an ophthalmologist at the Western Eye Hospital in West London, said he was not surprised that NICE had restricted the use of the drugs but was very surprised by the severity of the restriction.

'Both drugs are effective and patients tend to do better with them than without them,' he said.

'It is totally unacceptable for NICE to restrict the use of ranibizumab to patients who have been affected in both eyes.

'The drug should be given early because it becomes harder to treat AMD when both eyes are affected.'

Recent studies have shown that you do not have to give patients the full course of drugs to improve their AMD, thus lowering the costs, he said.

'But NICE does not take this into account and bases its calculations on the cost of a full course of drugs,' he added.

The drugs are not funded in Northern Ireland.

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