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Friday, 29 August 2008

Lucentis decision re-opens can of worms over NHS drug funding

The U-turn by NICE (the National Institute for Health and Clinical Excellence) this week regarding the sight-saving drug Lucentis, returns us once again to the debate about what the NHS should and shouldn't be funding.

Lucentis is used to treat wet age-related macular degeneration (AMD), the leading cause of sight loss in the UK.

But, in NICE's draft guidance last year it seemed to suggest a patient would need to lose their sight in one eye before the other could be treated with Lucentis. That has now changed, along with the introduction of a so-called "dose-capping system". The NHS will only fund 14 injections, with the cost of any more being met by the drug manufacturer.

It is still a costly course of treatment for the NHS. One Lucentis injection is £761.20, so the 14 injections being funded by the NHS equates to about £10,700.

This is money well spent, ensuring a loss of sight is avoided.

It has also ended the postcode lottery for patients in Wales, where some Local Health Boards were funding Lucentis and others weren't.

But where does that leave the NHS in terms of funding other "wonder" drugs?

How do you decide the cost "effectiveness" of such treatments?

We all know our health service doesn't have an endless pot of money, to be dipped into at a whim - which is why funding decisions must be transparent and clearly understood by clinicians and patients alike - based on evidence. It's also about the time the public is involved in the debate - after all it is our money!

But who has the guts to deny patients who've paid their National Insurance contributions all their lives, the treatment they need?

Perhaps none of our politicans have the appetite for that debate so soon after their summer holidays. But it is a debate they need to have.