South coast PCTs change wet AMD policy

 A PCT cluster on the south coast of England has abandoned its policy of allowing the use of unlicensed medication Avastin to treat wet AMD.

The Southampton, Hampshire, Isle of Wight and Portsmouth (SHIP) PCTs will now use only the licensed medication, Lucentis, for the eye condition.

The decision was prompted by a drop in the price of Lucentis and a legal challenge by its manufacturer, Novartis, to the use of Avastin.

While only Lucentis is licensed for the treatment of wet age-related macular degeneration, a widespread cause of blindness, the much cheaper Avastin is prescribed by some GPs.

The SHIP cluster’s decision in September 2011 to approve the use of Avastin in this indication is subject to a judicial review requested by Novartis.

The legal challenge made the policy impossible to implement, according to the cluster’s Board – especially given the impending handover of commissioning authority to CCGs.

Other factors driving the policy change were:

• The Royal College of Ophthalmologists supports the use of Lucentis, and this has driven nearly all prescribing decisions.

• New discounts for Lucentis have been agreed between SHIP and Novartis as part of a national patient access scheme.

Professor Jonathan Montgomery, Chairman of the PCT Cluster Board, said the Board remained convinced its policy was “lawful, sensible and safe”. However, it did not wish to leave an “undesirable legal legacy” to the region’s CCGs and the local area team of the NHS Commissioning Board.

More positively, he noted, “taking advantage of the significant discounts now being made available” would be “in the best interests of local patients”.

ABPI Chief Executive Stephen Whitehead commented: “It continues to be our view that off-label and unlicensed prescribing should be strictly limited to those circumstances where there is no licensed alternative.”