“Avastin vs Lucentis” – How the NHS pays over the odds for drugs

Radio 4’s Inside Health this week covered the story of two drugs, Avastin and Lucentis. This may seem like an obscure medical point, but the impact on taxpayers is real, and switching between the two could save £84 million.

Avastin is a cancer drug, but is used "off label" (ie used to treat a condition other than the one for which it was designed and licensed) to treat age-related macular degeneration (AMD). The National Institute for Health and Clinical Excellence (NICE) have licensed Lucentis for the treatment of AMD, but this drug costs nearly 12 times as much per dose as Avastin.

The leaders of 120 Clinical Commissioning Groups (CCGs) have called for a rethink and are asking for the barriers to the use of Avastin in treating AMD to be removed, saving taxpayers a great deal of money without compromising patient treatment. Clinical trials have shown Avastin to be safe for this use andas effective as Lucentis.

So what is the problem?

Both drug patents are owned by the pharmaceutical company Roche and having invested large sums developing Lucentis, Roche have a clear commercial interest in the use of the more expensive drug. Roche have not, and are very unlikely to, apply for a license for the use of Avastin in AMD.

So what should be done?

 Avastin and Lucentis are just one example amongst many where the NHS is paying over the odds for drugs. There must be a better solution to this sort of problem, and it is up to NICE to consider the cost to taxpayers when considering equally effective drugs.

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