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Avastin packs 'most cost-effective' punch

New study suggests the effectiveness of pricey anti-VEGF drugs does not outweigh their costs

Pound coins

The NHS and other health services would be better placed offering Avastin (bevacizumab) to diabetic macular oedema patients over its expensive anti-vascular endothelial growth factor (anti-VEGF) alternatives, according to a new study.

The benefits of anti-VEGF drugs were weighed up against their costs. In 2015, Eylea (aflibercept) cost $1850 (£1270), Lucentis (ranibizumab) cost $1170 (£800) and Avastin $60 (£40) per dose, according to the paper published online by JAMA Ophthalmology.

A total of 624 participants, split into three treatment groups, were tracked for a year. The effectiveness of the medication was then weighed up against the total cost of treatment.

While Eylea produced the greatest visual acuity gains, study author, Adam Glassman, of the Jaeb Center for Health Research in Florida, said these benefits came at a high cost.

Mr Glassman and his fellow researchers calculated that Eylea would have to be slashed to just 31% of its current cost and Lucentis to just 20% to make them cost-effective as the first-choice therapy.

“From a societal perspective, [Avastin] as first-line therapy for diabetic macular oedema would confer the greatest value, along with substantial cost savings versus the other agents. These results highlight the challenges that physicians, patients and policymakers face when safety and efficacy results are at odds with cost-effectiveness results.”

The research comes as National Institute for Health and Care Excellence (NICE) published provisional medical guidance that recommends another form of treatment, laser photocoagulation, ahead of Eylea.

Eylea is now recommended for patients for whom the laser treatment was unsuitable, or in cases where no benefits were seen.

Bayer, the company that owns the drug, announced it would challenge NICE’s ruling, citing the College of Ophthalmologist’s position that the newer anti-VEGF drugs offer patients better visual outcomes than laser photocoagulation.