ISLE of Wight NHS has announced is to no longer use Avastin to treat an eye-condition that causes blindness.
The Isle of Wight, which along with Southampton, Hampshire, Portsmouth PCTs, is part of the SHIP PCT cluster, faced a legal challenge over the use of the drug, which although cheaper, was not officially licensed for use to treat Wet Age-related Macular Degeneration.
A spokesman for SHIP said this evening (Wednesday): "At its meeting today, the Board of the Southampton, Hampshire, Isle of Wight and Portsmouth (SHIP) PCT Cluster decided to discontinue its policy on the use of Avastin for the treatment of Wet Age-Related Macular Degeneration (Wet AMD).
"The current policy was approved in September 2011 and made Avastin available to patients locally in addition to the drug Lucentis, which has been approved by NICE for the treatment of the disease.
"Since then, Novartis, the pharmaceutical company licensed to market Lucentis in the UK, sought and was granted permission for a judicial review of the cluster’s commissioning policy.
"The Board heard that, since the policy was agreed, a number of circumstances had made the policy difficult to implement:
• Although new research had emerged in the last year to provide a crucial comparison of the two drugs, which showed both as being very effective and broadly equivalent in their efficacy, further evidence would not be available for another 12-18 months when the UK study reached its two year conclusion
• On the whole, NHS consultant ophthalmologists had chosen not to prescribe Avastin. This followed guidance from the Royal College of Ophthalmologists in support of the continued use of Lucentis under the circumstances allowed for by NICE guidance.
• The legal challenge of the policy meant that, until legal proceedings concluded, the Cluster was unable to exert its policy with commissioned providers.
• The PCTs will be handing over commissioning authority to CCGs in April 2013 and, given the potential length of time needed to complete legal proceedings, the Cluster would find it increasingly difficult to commit CCGs to the policy.
• New discounts in the cost of Lucentis are now available. Despite the on-going legal proceedings, the PCT Cluster and Novartis have continued to work together to consider the best use of Lucentis under the current NICE guidance.
"A series of discussions between representatives from both organisations has resulted in an agreement to significant improvements in the cost of prescribing Lucentis. These form part of new arrangements under a National Patient Access Scheme which Novartis can now make available to NHS providers across the country."
Professor Jonathan Montgomery, Chairman of the PCT Cluster Board, said: "We remain of the view that the policy was lawful, sensible and safe for patients. However, in our consideration of the policy today, the Board has concluded that given the discount being offered, it will be possible to reduce significantly the £7.5 million spent annually on Lucentis in the SHIP area.
"The Board agreed that taking advantage of the significant discounts now being made available by Novartis, which have been introduced since the policy was agreed, was in the best interests of local patients.
"The Board also took into account that the policy had not been taken up in any meaningful way by consultant ophthalmologists on the advice of their Royal College. This has meant that the potential benefits we had envisaged, to both patients and the NHS, of offering Avastin as well as Lucentis, had not been realised.
"The Board was minded that Primary Care Trusts will no longer be responsible for commissioning from April 2013 and that, should the Judicial Review not conclude before then, or alternatively become the subject of an appeal, the PCT would be leaving an undesirable legal legacy for its succesors – Clinical Commissioning Groups and the local area team of the National Commissioning Board."
Chief Executive of the PCT Cluster, Debbie Fleming, said: "Patients with Wet AMD will notice no difference to their care as a result of this decision. Throughout the period of our review, patient treatment for Wet AMD had not been affected, with patients continuing to receive Lucentis in the usual way."
At the end of the meeting, the Board decided to 'revoke its policy and develop new commissioning arrangements that will secure the savings now available pending any further review post April 1, 2013 by SHIP Clinical Commisioning Groups and the National Commissiong Board local area team’.