NICE unsure of photodynamic therapy

Final NICE guidance on the Ambulight photodynamic therapy (PDT) device to treat non-melanoma skin cancer says there is not enough evidence to support its routine use in the NHS.

However, the device from Scottish company Ambicare Health remains one of the potential options while the evidence base is developed further.

Ambulight PDT consists of a battery-powered, disposable light-emitting device that is stuck to the skin with a disposable sticking plaster. It delivers an ambulatory therapy that can be used in the home or the community, whereas conventional PDT requires a hospital appointment.

In addition, Ambicare claims that the device’s lower irradiance makes it less painful for the patient than PDT sources.

The Medical Technologies Advisory Committee decided there was some evidence for the effectiveness of Ambulight PDT, but said the evidence on its use was too limited to support a recommendation for its routine adoption.

In particular, the cost data were too varied: the cost difference between Ambulight PDT and conventional PDT ranged from a saving per patient of £195 to an increase of £536, making firm conclusions difficult.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, commented: “The management of non-melanoma skin cancers imposes a significant workload on both primary and secondary care services, and therefore a device that offers PDT therapy in a community setting has the potential to have a positive impact on service provision.

However, she said, it was “uncertain” to what extent the relevant “changes in service provision” would result in benefits, as the evidence for the device’s efficacy was “of limited quantity”. NICE recommended that the device remain a treatment option in order to generate further evidence.

 
Ambulight PDT