Health trust will use AMD drug

MARK NICHOLLS Health chiefs yesterday pledged to press ahead with a revolutionary drug treatment that could stop patients going blind, despite a legal warning. Norfolk Primary Care Trust reaffirmed its position to treat wet age-related macular degeneration (AMD) with the drug Avastin despite it not being licensed for such use by the regulatory body the National Institute for Health and Clinical Excellence (Nice).

MARK NICHOLLS

Health chiefs yesterday pledged to press ahead with a revolutionary drug treatment that could stop patients going blind, despite a legal warning.

Norfolk Primary Care Trust reaffirmed its position to treat wet age-related macular degeneration (AMD) with the drug Avastin despite it not being licensed for such use by the regulatory body, the National Institute for Health and Clinical Excellence (Nice).

In May, the board took the step to decide to offer the treatment after it emerged that patients across Norfolk were being forced to pay for the drug out of their own pockets.


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Nice had issued draft guidelines earlier in the year, which suggested restricted use of other drugs for wet-AMD, but the further advice due out this month has now been delayed until next March.

The PCT had also taken legal advice on the matter which had recommended it would be unwise for the PCT to take a decision to fund Avastin until procedural issues had been addressed.

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However, Norfolk PCT has at this stage decided to press ahead with the treatment, currently being made available to about 30 patients, although the board has agreed to take a detailed look at the implications of that legal advice.

Director of public health Dr John Battersby said: "Avastin has been used quite widely for wet-AMD and there have not been any problems with Avastin.

"The board has decided to have a further look at the legal advice but we have decided to continue a service based on using Avastin."

Earlier, the board heard that several other PCTs were using the drug for wet-AMD with no major problems.

But it also emerged that the major NHS hospital in the Norfolk PCT area - the Norfolk and Norwich University Hospital, as well as the Queen Elizabeth Hospital at King's Lynn - are refusing to offer treatment for wet-AMD based on the Avastin approach because of the legal fears and lack of clinical trials for that use.

Dr Battersby said the 30 patients the PCT is funding are being treated by a private-sector provider in Norwich.

Earlier in the year, the debate was over whether to prescribe drugs called Lucentis or Macugen or go for Avastin, which is designed for a different treatment but has proved effective for wet-AMD.

Nice has also suggested that treatment should only be given on a second eye after sight was lost in the first, although Norfolk PCT has rejected this and is offering the treatment on the first eye before the second shows major symptoms.

Figures presented to the board yesterday say Lucentis would cost £10-11,000 a year to treat a person, while Avastin is half that price.

The annual cost to the PCT to treat patients with Avastin would be about £360,000.

cOMMENT - Page 18

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