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Rethink over sight-saving drugs Rethink over sight-saving drugs
(2 days later)
The NHS drug watchdog in England and Wales is to reconsider controversial guidance limiting the use of drugs for a leading cause of blindness.The NHS drug watchdog in England and Wales is to reconsider controversial guidance limiting the use of drugs for a leading cause of blindness.
The National Institute for Health and Clinical Excellence (NICE) assessed treatments for wet age-related macular degeneration (wet AMD).The National Institute for Health and Clinical Excellence (NICE) assessed treatments for wet age-related macular degeneration (wet AMD).
Draft guidance recommended a total block on one drug, Macugen, and tight restrictions on a second, Lucentis.Draft guidance recommended a total block on one drug, Macugen, and tight restrictions on a second, Lucentis.
However, the decision generated more than 13,000 complaints - a record.However, the decision generated more than 13,000 complaints - a record.
This overwhelming surge of public opinion could simply not be ignored Steve WinyardRNIBThis overwhelming surge of public opinion could simply not be ignored Steve WinyardRNIB
They included submissions in support of the drugs from the Royal College of Nursing and the Royal College of OphthalmologistsThey included submissions in support of the drugs from the Royal College of Nursing and the Royal College of Ophthalmologists
NICE has announced it will now carry out further "economic modelling" of the drugs. The final guidance will not now be published until next year.NICE has announced it will now carry out further "economic modelling" of the drugs. The final guidance will not now be published until next year.
Few benefittedFew benefitted
The draft guidance recommended that Lucentis only be made available to patients with a particular type of wet AMD called predominantly classic subfoveal choroidal neovascularisation (CNV) - about 20% of the total. The draft guidance recommended that Lucentis, technical name ranibizumab, only be made available to patients with a particular type of wet AMD called predominantly classic subfoveal choroidal neovascularisation (CNV) - about 20% of the total.
Even then, it said the drug should only be funded by the NHS when both eyes were affected - and only used to treat the less affected eye.Even then, it said the drug should only be funded by the NHS when both eyes were affected - and only used to treat the less affected eye.
The RNIB accused NICE of "massive incompetence" in delaying a decision on access to the drugs.The RNIB accused NICE of "massive incompetence" in delaying a decision on access to the drugs.
It said the review could lead to 10,000 people in the UK going blind unnecessarily in the next six months.It said the review could lead to 10,000 people in the UK going blind unnecessarily in the next six months.
Head of campaigns Steve Winyard said: "RNIB is extremely grateful to the thousands of people who expressed their horror at the NICE proposals to deny people sight-saving treatment.Head of campaigns Steve Winyard said: "RNIB is extremely grateful to the thousands of people who expressed their horror at the NICE proposals to deny people sight-saving treatment.
"This overwhelming surge of public opinion could simply not be ignored - and it's a great victory for the British public."This overwhelming surge of public opinion could simply not be ignored - and it's a great victory for the British public.
"But given the wealth of evidence that NICE received at the start of this process, how could they have got their initial guidance so wrong?""But given the wealth of evidence that NICE received at the start of this process, how could they have got their initial guidance so wrong?"
Many affectedMany affected
Wet AMD is the leading cause of sight loss in the UK, and affects around a quarter of a million people. There are 26,000 new cases each year.Wet AMD is the leading cause of sight loss in the UK, and affects around a quarter of a million people. There are 26,000 new cases each year.
AMD affects the macula - the central part of the retina at the back of the eye responsible for the vision necessary for everyday activities such as reading, driving and identifying faces.AMD affects the macula - the central part of the retina at the back of the eye responsible for the vision necessary for everyday activities such as reading, driving and identifying faces.
The wet form of AMD is very aggressive and responsible for 90% of cases of blindness caused by the condition - more than 18,000 people a year in the UK.The wet form of AMD is very aggressive and responsible for 90% of cases of blindness caused by the condition - more than 18,000 people a year in the UK.
It results in new blood vessels growing behind the retina, which are unstable and tend to leak fluid and blood, leading to scarring and sight loss.It results in new blood vessels growing behind the retina, which are unstable and tend to leak fluid and blood, leading to scarring and sight loss.
Both Macugen and Lucentis, which are delivered by injection, are from a class known as anti-VEGF drugs, which work by targeting a protein that helps the formation of new blood vessels. Both Macugen, technical name pegaptanib, and Lucentis, which are delivered by injection, are from a class known as anti-VEGF drugs, which work by targeting a protein that helps the formation of new blood vessels.
Macugen costs about £10,000 a year, and Lucentis about £12,000.Macugen costs about £10,000 a year, and Lucentis about £12,000.
Both drugs have been made widely available in Scotland.Both drugs have been made widely available in Scotland.