NHS bosses win landmark legal battle against drug firms

NHS bosses have today won a landmark legal battle against two multinational drug firms which they say will save the tax payer millions of pounds in the treatment of the biggest cause of sight loss in the UK.

Today's victory for the 12 Clinical Commissioning Groups (CCGs) in the North of England - covering Sunderland, South Tyneside and Hartlepool - means they can now offer Avastin as a treatment to patients with wet age-related macular degeneration (wet AMD).

Novartis and Bayer were trying to stop NHS doctors from prescribing a cheaper treatment for a serious eye condition.

Health bosses said the ruling may reduce the power of companies to set prices.

Drug company Novartis said they were "deeply disappointed" because patients were being asked to accept an unlicensed treatment to save the NHS money.

Cathy Yelf, chief executive of the Macular Society, said: "It is undoubtedly helpful to the NHS to have this cheaper drug available for wet age-related macular degeneration. The savings must be reinvested in AMD clinics, many of which are failing to treat patients in line with guidelines. This leads to unnecessary and tragic sight loss. 

"We understand the concerns of the industry and would not support any weakening of the drug regulatory processes. It is very important that the licensed drugs remain available because some patients respond better to one drug than others. We would welcome moves by the industry to further reduce the cost of the licensed drugs so that the use of an unlicensed alternative is less attractive."

David Hambleton, chief executive officer of NHS South Tyneside clinical commissioning group (CCG), one of the NHS groups involved in the case, welcomed the judgment, saying it was a good day for patients and the NHS.

"We've always said we think that it's important that patients should have the choice of a very effective treatment for wet AMD, and it's actually a fraction of the cost of the other alternatives.

"So I think what we do now is offer patients that choice. We believe that they will support very strongly having a cost-effective, safe treatment and saving the NHS generally a lot of money. It is a victory for common sense over commercial interests."

The NHS groups were offering patients a choice between Lucentis and Eylea - drugs licensed for eye treatment - and the far cheaper drug Avastin, which is recommended by the World Health Organisation (WHO) for treating eyes, but only licensed for cancer treatment in the UK.

Novartis and Bayer manufacture the two more expensive licensed drugs - Lucentis which costs £561 and Eylea which costs £800.

By comparison, Avastin costs about £28 per injection.

Avastin is widely used around the world, particularly in the US, but is not currently licensed in the UK.

In January, the National Institute for Health and Care Excellence (NICE) concluded that Avastin was as safe and effective as the two licensed drugs, Lucentis and Eylea.

Mike Burdon, president of the Royal College of Ophthalmologists, said: "Licensing laws are designed to protect patients from poorly regulated unproven drugs, but it is the drug companies' responsibility to apply for a licence.

"We are treating 40,000 new diagnoses of wet AMD annually - the saving could amount to £500 million a year. This amounts to one district hospital being built annually."

Responding to the ruling, a spokesperson from pharmaceutical company Novartis said: "Novartis is deeply disappointed in this decision and remains of the opinion that the policy undermines the well-established legal and regulatory framework that is there to protect both patients' safety and to ensure health care professionals can prescribe with confidence."