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Landmark court ruling follows findings of NIHR-funded study

Published: 27 September 2018

A drug at the centre of a landmark court ruling which could save the NHS millions was identified as clinically and cost-effective by a 2015 NIHR-funded eye treatment study.

The NHS last week won a legal battle with two drug companies to be able to prescribe Avastin, a treatment for patients with wet age-related macular degeneration (AMD) – a serious eye condition that causes severe impairment of the central vision in both eyes.

The IVAN trial, funded in 2007 and published in 2015, investigated two drugs that are used to stop leakage from blood vessels inside the eye.

It found that wet AMD could be treated with bevacizumab (Avastin®), which is non-licensed but far cheaper than the licensed Ranibizumab (Lucentis®). While Avastin costs £28 per injection,  Lucentis costs £551. It is thought the use of Avastin could lead to savings of hundreds of millions per year to the NHS.

The study, which assessed 610 patients across 23 hospital ophthalmology clinics in England, Wales and Northern Ireland, showed that the Bevacizumab was neither worse nor better than Ranibizumab in terms of best corrected visual acuity.

The findings acted as the basis for recommendations made in the World Health Organisation’s (WHO) 2017 report ‘The selection and use of essential medicines’, in addition to informing NICE clinical guidelines on the treatment of wet AMD.

Lead researcher Professor Usha Chakravarthy, of Queen’s University, Belfast, said: “The team welcome the fact that the NHS will have the opportunity to extend the use of Avastin to routine clinical practice.”

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