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The Association of the British Pharmaceutical Industry (ABPI) has said a high court decision allowing clinicians to give a drug typically used to treat cancer to patients with deteriorating eye sight “undermines the regulation of all medicines.”

Avastin, which is 30 times cheaper than two other treatments for age-related macular degeneration (AMD) – Lucentis which is manufactured by Novartis and Eylea which is made by Bayer – will be available to patients suffering with the eye condition after the court backed a case brought by 12 clinical commissioning groups (CCGs) in the North-East of England.

Avastin costs £28 for an injection compared with £561 for Lucentis and £800 for Eylea. Earlier this year the National Institute for Health and Care Excellence said Avastin, which had only been licensed for the treatment of cancer in the UK, was as safe and effective as the other two more expensive treatments for wet AMD.

Dr Lawrence Gnanaraj, consultant ophthalmologist and clinical director at the Sunderland Eye Infirmary, was quoted in the Hartlepool Mail as saying: “(This) decision is very positive news not only for our patients here in Sunderland and the North East but potentially across the whole NHS.

“As clinicians we understand the importance of ensuring value for money for the NHS and we have supported the introduction of a policy across the North East and North Cumbria which not only offers increased patient choice but also has the potential to substantially reduce costs for the NHS which can be reinvested directly back into patient care.

“Ultimately, the treatment decision for every individual patient will always be based on efficacy, safety and fully informed patient choice. (This) ruling means we can now offer our patients the choice of Avastin which the National Institute for Health and Care Excellence (NICE) has found to be just as clinically safe and effective.”

However, Dr Sheuli Porkess, deputy chief scientific adviser to the ABPI, said: “We will consider this judgement carefully. Patients and doctors need total clarity on who determines whether medicines work and are safe to be used.

“This extraordinary judgement potentially undermines the regulation of all medicines and by doing that, neither patients nor doctors have clarity on what information to trust.

“As we exit the EU and the UK government is looking for regulatory co-operation between the UK and the EU, this confusion is deeply unhelpful.”

Royal Pharmaceutical Society president Ash Soni said the court’s decision was “a landmark ruling and good news for patients and the NHS.”

He added: “Avastin is licensed as a cancer treatment in the UK because the manufacturer has not sought a licence for any other purpose.

“Avastin has been shown through real world evidence to be a safe and effective for treatment for age related wet macular degeneration. The additional bonus is that it saves the NHS a significant amount of money, which can then be used to help other patients.

“Patients should always be involved in decision-making around the medicines they take whenever possible.”

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