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Allow NHS doctors to prescribe effective sight loss drug, said The BMJ

2 April 2015

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NHS doctors should be allowed to prescribe a cheap, safe and effective drug for the degenerative eye disease, wet age related macular degeneration (AMD) – a leading cause of blindness among older patients, said an investigation by The British Medical Journal (The BMJ).

Editor in chief, Dr Fiona Godlee, said the new evidence “raises questions about the legal and regulatory positions that have skewed clinical practice, fuelled NHS drug costs, and left doctors confused about what they can and can’t prescribe”.

Dr Godlee said: “Doctors and academics have carried out clinical trials despite threats and intimidation – and doctors’ leaders should follow suit and not allow themselves to be bullied either. Patients have volunteered to participate in clinical trials thinking that their contribution might save the NHS millions of pounds. It is unethical not to act on their altruism.”

She added: “Doctors’ leaders also need to sort out the web of misinformation about drug prescribing that has been generated behind closed doors and is costing the NHS hundreds of millions of pounds a year by scaring doctors from using cheap and effective medicines.”

The licensed treatment, lucentis (ranibizumab) is estimated to cost $1950 per dose compared with $50 per dose for Avastin (bevacizumab), which is not licensed for AMD. Both drugs are owned by the same company (Roche), although lucentis is marketed by Novartis in the UK.

Publicly funded trials have shown that bevacizumab is as safe and effective as ranibizumab – and allowing its use could release £102m a year that the NHS could reinvest in other frontline patient services.

Yet new evidence uncovered by The BMJ reveals a campaign by the drug manufacturers to “undermine and divert attention” from the results of these trials, even turning to the charity, Royal National Institute of Blind People (RNIB), for help.

Emails obtained under a freedom of information request show that clinicians with ties to Novartis urged some primary care trusts to pull out of one trial. The BMJ has also learnt of attempts by Novartis to “derail” a second publicly funded UK trial.