Use of drug Avastin to treat eye condition macular degeneration in Sussex supported

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Tough questions asking whether to offer patients an ‘effective’ but unlicensed drug to treat sight loss have been made easier thanks to a High Court ruling.

The governing bodies of five clinical commissioning groups – Brighton & Hove, Crawley, East Surrey, High Weald Lewes Havens, and Horsham & Mid Sussex – were due to consider the pros and cons of offering Avastin to treat age-related macular degeneration as a cheaper alternative to the currently used Lucentis.

The groups, working together as the Central Sussex and East Surrey Commissioning Alliance (CSESCA), met in Ardingly on Tuesday (September 25) where it was reported that using Avastin would lead to savings of more than £200,000 per month.

The drug is used elsewhere in the world to treat eye conditions, but in the UK it is only licenced to treat certain types of cancer.

There had been concern among the CCGs about the legal consequences of offering it for an unlicensed use.

However, on September 21, the High Court ruled against pharmaceutical giants Novartis and Bayer, who brought a case against 12 northern CCGs for offering Avastin.

While Novartis described the ruling as ‘disappointing’ and ‘a bad day for patients, doctors and the NHS’, it eased the pressure on CSESCA, which already wanted to support the use of the drug.

Members were asked to agree that CCGs would work with healthcare providers such as the Sussex & Surrey Healthcare Trust and the East Sussex Healthcare Trust, to offer Avastin, with a number of provisos.

They included the need for patients to be fully informed about the options open to them, and the need to ensure they would be offered equal treatment whichever drug they chose.

It was agreed that Avastin should be limited to new patients only, as CSESCA did not have evidence showing it would be safe for patients to change treatment mid-way through the process.

The meeting was told that doctors in Brighton were already ‘champing at the bit’ to get started.

But, with the possibility of an appeal from Novartis and Bayer, members were warned that there could still be an ‘unresolved legal position’.

It was suggested that NHS England should be approached for guidance in the meantime.