Lucentis: the eyes don’t have it

A diabetic man from York with serious sight problems still considers himself very fortunate – because he’s been lucky enough to find someone prepared to pay privately for his treatment for macular oedema.

NHS patients are being denied the Lucentis injections he benefits from after the National Institute for Health and Clinical Excellence (NICE), responsible for overseeing drug use in the NHS, ruled it was not cost-effective compared with laser treatment.

Appeal

Although the decision has been open to appeal it is anticipated that the final announcement, due shortly, will confirm that the UK’s estimated 10,000 affected diabetics will be treated differently to patients with age-related macular degeneration.

The latter will continue to receive Lucentis, which accounted for 1 per cent of the entire NHS drugs budget last year. Some primary care trusts prefer to use the much cheaper Avastin, a cancer drug that has proven to be effective in treating macular oedema.

The macular is the central part of the retina responsible for colour vision and fine detail. A change in retinal blood vessels can create the conditions for excess fluid that can lead to severe visual impairment in the affected eye.

Diabetes

Stephen Moore, 34 and married with one young son, began experiencing problems with his eyes after being diagnosed with diabetes ten years ago. He had laser treatment on his right eye and then steroid injections in both eyes, all paid for by the NHS.

“In both cases the improvement was minimal,” said Moore, who feared he might have to give up his IT job and asked his employer’s occupational health department for help.

“They told me about the Access to Work scheme, funded by the government to help disabled people do their job, which is good, but even with such help I couldn’t have continued to do my current job,” said Moore.

An eye consultant told Moore about Lucentis, available privately whilst NICE considered whether to make it available on the NHS. Moore believes the 23 injections he’s had are working, and passed a DVLA test allowing him to continue driving this year.

Private funds

But the Lucentis injections cost £700 a time. Moore doesn’t know how many he may still require and is worried that the private funds he currently enjoys could end.

He is backing the campaign by the Royal National Institute of Blind People to persuade NICE to change its mind.

Longer-term care

“My good luck doesn’t mean I am happy seeing other people denied a drug that can massively improve their lives,” said Moore.

“It’s not cheap but they already provide it to one section of the community. Furthermore denying people the injections might cost the taxpayer a considerable sum because there will be the need to provide longer-term care support for someone who can’t see and function effectively.

“People like myself who are working won’t be able to do so, and tax revenues will be lost.”

A NICE spokesperson said the organisation would shortly announce its final decision on Lucentis.

Photo: Stephen Moore says privately funded Lucentis injections have helped his failing sight (Mark Metcalf)