The NHS could save more than pounds 84m a year if it used a cheap, unlicensed drug to treat people in danger of going blind rather than the expensive one currently licensed and promoted by leading pharmaceutical companies for the purpose, a ground-breaking trial has shown.

Researchers led by Prof Usha Chakravarthy from Queen’s University Belfast have provided an answer to the question of whether the cancer drug Avastin can safely be used to treat people with wet age-related macular degeneration (AMD), the most common cause of blindness.

Their conclusion at the end of a two-year trial, published today in the Lancet, is that the bowel cancer drug Avastin – which is cheap because one dose can be split into many – is just as good for this purpose as Lucentis, marketed by the drug company Novartis for more than 10 times the price. One shot of Avastin costs pounds 60, while a dose of Lucentis sells for pounds 700.

Many doctors, first in the United States and now worldwide, have been giving their patients Avastin because of the cost, but Genentech, which developed both drugs, Roche, which markets Avastin for bowel cancer but not AMD, and Novartis, which sells Lucentis, have attempted to stop them, arguing that Avastin is not licensed for this use. Doctors in Southampton, the Isle of Wight and Portsmouth dropped plans to use Avastin when Novartis made a legal challenge.

The trial led by Chakravarthy found that sight was equally well preserved with either drug – and that giving patients regular monthly injections worked better than less frequent shots. The NHS should now look at putting the increasing numbers of people with wet AMD on Avastin rather than Lucentis, the team believes.

“The logical thing is to get everybody treatment every month with the cheaper drug,” said Chakravarthy.

At least 23,000 people have wet AMD diagnosed every year and will suffer sight loss within two years if not treated. The two drugs have now been investigated by eye specialists from 23 hospitals and universities in the UK for the past five years.

Prof Simon Harding, from the University of Liverpool and the St Paul’s eye unit at Royal Liverpool university hospital, said: “Avastin is already used to treat wet AMD in some parts of the UK and extensively elsewhere in the world.”

The Department of Health said: “We have no immediate plans to refer Avastin to the National Institute for Health and Care Excellence (NICE) for appraisal, but we are keeping this position under review.”

Polly Toynbee, page 32 ≥ pounds 60

The cost of one shot of Avastin. A dose of Lucentis sells for pounds 700. The two drugs have been investigated by eye specialists

 

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