Eye disease 'wonder drug' hope

The National Institute for Health and Clinical Excellence (Nice) has recommended the drug Lucentis after performing a U-turn on draft guidance published last year.

The move was welcomed by the Royal National Institute for the Blind (RNIB), which has campaigned for Lucentis for thousands of people with wet age-related macular degeneration (AMD).

AMD is the leading cause of sight loss in the UK and destroys the central region of the retina, the macula, leading to progressive loss of sight.

It comes in two forms - wet and dry - with the dry form being far more common. However, the wet type is the more aggressive and accounts for around 90% of blindness caused by the condition.

The final guidance, which applies to England, Wales and Northern Ireland, recommends Lucentis (also called ranibizumab) for treating wet AMD. The drug is already approved in Scotland. The guidance rejects another drug - Macugen (pegaptanib) - as not cost-effective.

In December, Nice dropped one of the most controversial aspects of its draft guidance, which suggested that patients would need to lose sight in one eye before the other could be treated.

Nice recommends the use of Lucentis as long as several conditions are met in the eye to be treated, including evidence of recent progression of the disease and no permanent structural damage to the central fove - the centre most part of the macula. It also states that the NHS will only fund 14 injections, with the cost of any more being met by the manufacturer, in this case Novartis.

This "dose-capping" scheme was recommended by Novartis and has been agreed with the Department of Health. It will see Novartis reimburse the NHS for any additional jabs.

The cost of a single Lucentis injection is £761.20 (excluding VAT). The two-year cost of Lucentis is about £10,700, assuming eight injections in the first year and six injections in the second year.