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NHS could save £85m a year by using off-label treatment for macular degeneration, says study

The NHS could save £85m annually if it switched to using an alternative treatment for macular degeneration, according to a new study that has sparked a debate on the off-label use of medicines.

The IVAN study showed that the cancer drug bevacizumab had ‘similar efficacy and safety' to the licensed alternative, ranibizumab (Lucentis), for the treatment of macular degeneration.

It comes as the manufacturer of ranibizumab seeks a judicial review to prevent PCTs from recommending the unlicensed alternative.

The judicial review will be a crucial legal test case, as the GMC looks at whether it should place a ban on all off-label prescribing where there is a licensed alternative, as revealed by Pulse last month.

The data, due to be published shortly in the journal Opthalmology, showed a non-significant difference in visual acuity using the drugs of -1.99, but a significant cost difference of £3,258 between drugs over one year. The UK researchers reported no significant differences in the overall adverse event profile between the two drugs, although there were ‘slightly more' systemic serious adverse events with bevacizumab. The analysis, seen by Pulse, concludes: ‘Considering all of the evidence now available, we conclude that ranibizumab and bevacizumab confer equivalent visual function benefits, but that bevacizumab is substantially less expensive.' A statement from Novartis said: ‘Although the IVAN trial will help contribute to the existing data for treating wet AMD, it is unable to fully answer questions around the efficacy and safety of unlicensed intravitreal bevacizumab for use in the eye.' 'IVAN is not designed to the same standard as trials which are used to make regulatory decisions.'       

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